Fernandes, Eustace S.
Fernandes, Eustace S. is an individual health care provider with primary practice located at 7916 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Fernandes, Eustace S. can be contacted via phone (260) 432-2297.Contact Information
Primary practice address
7916 W Jefferson Blvd
Fort Wayne IN 46804-4140
Phone: (260) 432-2297
Fax: (260) 434-6481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01060794A | Indiana |
Profile Details
| NPI number | 1821040791 |
|---|---|
| LBN Legal business name | Fernandes, Eustace S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Sep 23rd, 2020 - about 4 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 | 1821040791 | NPPES |
| Indiana | MEDICAID | 200518950 |
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