Provider Demographics
NPI:1124140769
Name:MOREIRA, FERNANDA (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDA
Middle Name:
Last Name:MOREIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DR STE 850
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-702-2007
Mailing Address - Fax:
Practice Address - Street 1:4515 PREMIER DR STE 204
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8356
Practice Address - Country:US
Practice Address - Phone:336-802-2075
Practice Address - Fax:336-802-2076
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911386Medicaid
NC2073260AMedicare PIN
NCZR0000094Medicare UPIN