Provider Demographics
NPI:1801057146
Name:FERNANDES, JOSHUA KIRAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:KIRAN
Last Name:FERNANDES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 MEDICAL PARK DR STE 303
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-754-1200
Mailing Address - Fax:855-673-8462
Practice Address - Street 1:2101 MEDICAL PARK DR STE 303
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:318-325-2020
Practice Address - Fax:318-388-0000
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0086891207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2372831Medicaid
LA359109ZHQ6Medicare Oscar/Certification