Provider Demographics
NPI:1700191947
Name:FERNANDES, HERMINA DEEPIKA (MBBS, FACP)
Entity Type:Individual
Prefix:DR
First Name:HERMINA
Middle Name:DEEPIKA
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:MBBS, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7695 S RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1812
Mailing Address - Country:US
Mailing Address - Phone:480-256-1664
Mailing Address - Fax:480-726-1854
Practice Address - Street 1:7695 S RESEARCH DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1812
Practice Address - Country:US
Practice Address - Phone:480-256-1664
Practice Address - Fax:480-726-1854
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ65496207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program