Fernando, Israel V
Fernando, Israel V is an sole proprietor health care provider with primary practice located at 3709 16Th St , Moline IL 61265-7208. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Fernando, Israel V can be contacted via phone (309) 797-2713.Contact Information
Primary practice address
3709 16Th St
Moline IL 61265-7208
Phone: (309) 797-2713
Fax: (309) 797-9558
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036-101791 | Illinois |
Profile Details
| NPI number | 1558473850 |
|---|---|
| LBN Legal business name | Fernando, Israel V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Sep 9th, 2016 - about 8 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 | 1558473850 | NPPES |
| Iowa | MEDICAID | 2252064 |
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