Provider Demographics
NPI:1700945805
Name:ARTEAGA, FERNANDO A (OD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:A
Last Name:ARTEAGA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:331 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2033
Mailing Address - Country:US
Mailing Address - Phone:215-672-4300
Mailing Address - Fax:215-672-9524
Practice Address - Street 1:8 MORTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2210
Practice Address - Country:US
Practice Address - Phone:610-521-2111
Practice Address - Fax:610-521-3048
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA619840OtherIBC
PA619840OtherHIGHMARK BS
2543183OtherAETNA
687877411001OtherCIGNA
PA0824068000OtherKHPE
36784004OtherDAVIS VISION
P11159545OtherMULTIPLAN
PAU84521Medicare UPIN
PA0824068000OtherKHPE
2543183OtherAETNA