Carlos, Fernando

Carlos, Fernando is an individual health care provider with primary practice located at 190 Welles St , Kingston PA 18704-4968. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Carlos, Fernando can be contacted via phone (570) 718-4140.

Contact Information

Primary practice address
190 Welles St Kingston PA 18704-4968
Phone: (570) 718-4140
Fax: (570) 718-4141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD 0583251 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD058325L Pennsylvania

Profile Details

NPI number 1871590372
LBN Legal business name Carlos, Fernando
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Aug 25th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871590372 NPPES
Pennsylvania MEDICAID 1590725

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