Provider Demographics
NPI:1609261171
Name:HERNANDEZ, PAUL TARVER (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:TARVER
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3737 MARKET STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5544
Mailing Address - Country:US
Mailing Address - Phone:215-662-8664
Mailing Address - Fax:215-243-4649
Practice Address - Street 1:3737 MARKET STREET
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5544
Practice Address - Country:US
Practice Address - Phone:215-662-8664
Practice Address - Fax:215-243-4649
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2023-10-16
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Provider Licenses
StateLicense IDTaxonomies
PAMD462210208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery