Basic Information
Provider Information
NPI: 1508969676
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERNANDEZ
FirstName: ARTURO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2024 GEORGIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200013027
CountryCode: US
TelephoneNumber: 2028653415
FaxNumber: 2028656876
Practice Location
Address1: 2041 GEORGIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200600001
CountryCode: US
TelephoneNumber: 2028653785
FaxNumber: 2028653131
Other Information
ProviderEnumerationDate: 09/06/2006
LastUpdateDate: 09/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XMD33520DCN Allopathic & Osteopathic PhysiciansSurgery 
204F00000XMD33520DCY Allopathic & Osteopathic PhysiciansTransplant Surgery 

ID Information
IDTypeStateIssuerDescription
40778730005MD MEDICAID
03680180005DC MEDICAID
01016995005VA MEDICAID


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