Fernando, Marylou David
Fernando, Marylou David is an sole proprietor health care provider with primary practice located at 1113 Garredd Blvd Ste B , Augusta GA 30909-6757. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Fernando, Marylou David can be contacted via phone (706) 364-8220.Contact Information
Primary practice address
1113 Garredd Blvd Ste B
Augusta GA 30909-6757
Phone: (706) 364-8220
Fax: (706) 922-5856
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 028770 | Georgia |
Profile Details
| NPI number | 1881644045 |
|---|---|
| LBN Legal business name | Fernando, Marylou David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2006 |
| Last updated | Feb 22nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881644045 | NPPES |
| Georgia | MEDICAID | 00344132H |
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