Provider Demographics
NPI:1467659854
Name:FUENMAYOR-CARDOZO, FRANKLIN ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:ENRIQUE
Last Name:FUENMAYOR-CARDOZO
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:PO BOX 26970
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221-6970
Mailing Address - Country:US
Mailing Address - Phone:478-254-7353
Mailing Address - Fax:478-254-7350
Practice Address - Street 1:2525 2ND ST
Practice Address - Street 2:STE 150
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-2223
Practice Address - Country:US
Practice Address - Phone:478-254-7353
Practice Address - Fax:478-254-7350
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067885207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology