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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881644045 NPPES
Georgia MEDICAID 00344132H

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