Hernandez, Mario Augusto
Hernandez, Mario Augusto is an sole proprietor health care provider with primary practice located at 18509 Statesville Rd Ste B1 , Cornelius NC 28031-5703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hernandez, Mario Augusto can be contacted via phone (704) 237-3421.Contact Information
Primary practice address
18509 Statesville Rd Ste B1
Cornelius NC 28031-5703
Phone: (704) 237-3421
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 16949 | Puerto Rico |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101244562 | Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2010-00567 | North Carolina |
Profile Details
| NPI number | 1700060092 |
|---|---|
| LBN Legal business name | Hernandez, Mario Augusto |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 21st, 2007 |
| Last updated | Dec 6th, 2011 - about 13 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 | 1700060092 | NPPES |
| North Carolina | MEDICAID | 5915310 | |
| North Carolina | MEDICAID | 7100062480 |
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