Provider Demographics
NPI:1447313952
Name:FERNANDEZ, CELIA M (MD)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:M
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CELIA
Other - Middle Name:
Other - Last Name:FERNANDEZ-BOTELHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:117 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3511
Mailing Address - Country:US
Mailing Address - Phone:256-291-8877
Mailing Address - Fax:256-737-8008
Practice Address - Street 1:117 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3511
Practice Address - Country:US
Practice Address - Phone:256-291-8877
Practice Address - Fax:833-319-3812
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33566207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23426XMedicare PIN
C56864Medicare UPIN