Provider Demographics
NPI:1053756254
Name:FERNANDO, HARENDRA N (MD)
Entity type:Individual
Prefix:DR
First Name:HARENDRA
Middle Name:N
Last Name:FERNANDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4850 SUGARLOAF PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2860
Mailing Address - Country:US
Mailing Address - Phone:404-855-2228
Mailing Address - Fax:404-793-8997
Practice Address - Street 1:650 NORTH AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2749
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0070695207Q00000X
AZ66761207Q00000X
NC2023-03051207Q00000X
GA76714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine