Provider Demographics
NPI:1073559969
Name:HERNANDEZ, CAROLINA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:MARIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 GARRISONVILLE RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1532
Mailing Address - Country:US
Mailing Address - Phone:540-318-8167
Mailing Address - Fax:540-318-8165
Practice Address - Street 1:450 GARRISONVILLE RD
Practice Address - Street 2:SUITE 215
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1532
Practice Address - Country:US
Practice Address - Phone:540-318-8167
Practice Address - Fax:540-318-8165
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101242691207R00000X
NC2000-01159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH45943Medicare UPIN