Doctor Name: | PATRICK S FERNANDES |
NPI Number: | 1033172655 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036102220 |
Business Practice Address: | 407 E Vernon Ave Normal, IL - 617613813 |
Business Phone Number: | 3094512231 |
Business Fax Number: | 3094512299 |
Mailing Address: | 407 E Vernon Ave, NORMAL |
State: | IL |
Postal Code: | 617613813 |
Phone Number: | 3094512231 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2006 |
NPI Last Update Date: | 10/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0001X |
License Number: | 036102220 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Radiation Oncology |
Taxonomy Definition: | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |