Provider Demographics
NPI:1699774141
Name:FERNANDEZ, RAYMOND N (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:N
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4198 US HIGHWAY 431
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0212
Mailing Address - Country:US
Mailing Address - Phone:256-891-8580
Mailing Address - Fax:256-891-8581
Practice Address - Street 1:4198 US HIGHWAY 431
Practice Address - Street 2:SUITE A
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0212
Practice Address - Country:US
Practice Address - Phone:256-891-8580
Practice Address - Fax:256-891-8581
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00022283207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009922285Medicaid
AL51515286OtherBCBS OF ALABAMA
AL51515286OtherBCBS OF ALABAMA
AL051553555Medicare PIN