Provider Demographics
NPI:1962199687
Name:FERNANDO, HEVANSHI (MD)
Entity type:Individual
Prefix:DR
First Name:HEVANSHI
Middle Name:
Last Name:FERNANDO
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822
Mailing Address - Country:US
Mailing Address - Phone:570-214-5349
Mailing Address - Fax:
Practice Address - Street 1:GEISINGER WYOMING VALLEY MEDICAL CENTER
Practice Address - Street 2:1000 E MOUNTAIN DRIVE
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711
Practice Address - Country:US
Practice Address - Phone:570-808-3746
Practice Address - Fax:570-808-5967
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program