Fernandez, Mary C

Fernandez, Mary C is an individual health care provider with primary practice located at Hospital Based @ Community Memorial W180 N8085 Town Hall Road, Menomonee Falls WI 53051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Fernandez, Mary C can be contacted via phone (414) 805-3666.

Contact Information

Primary practice address
Hospital Based @ Community Memorial W180 N8085 Town Hall Road Menomonee Falls WI 53051
Phone: (414) 805-3666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 18322 Wisconsin

Profile Details

NPI number 1396799656
LBN Legal business name Fernandez, Mary C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jul 8th, 2007 - about 18 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 1396799656 NPPES
Wisconsin MEDICAID 30118400

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