Provider Demographics
NPI:1881858439
Name:FERNANDEZ, MARIFEL M (MD)
Entity Type:Individual
Prefix:
First Name:MARIFEL
Middle Name:M
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-641-6200
Mailing Address - Fax:651-641-6205
Practice Address - Street 1:2500 COMO AVENUE
Practice Address - Street 2:MS 31100A - HEALTHPARTNERS COMO CLINIC
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1460
Practice Address - Country:US
Practice Address - Phone:650-641-6200
Practice Address - Fax:651-641-6205
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2019-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI51422207Q00000X
MN54413207QS0010X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine