Provider Demographics
NPI:1083657761
Name:FERNANDEZ, EDDIE ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:ALEJANDRO
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1500 FOREST GLEN ROAD
Mailing Address - Street 2:HOLY CROSS HOSPITAL
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-754-7500
Mailing Address - Fax:
Practice Address - Street 1:10750 COLUMBIA PIKE
Practice Address - Street 2:SUITE 605
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:301-891-6040
Practice Address - Fax:240-473-4321
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD000064008207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC020615S58Medicare PIN