MR. FERNANDO A. DURALDE (NPI# 1407856552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407856552 |
| Entity Type | Individual |
| Full Name | MR. FERNANDO A. DURALDE |
| Credential | M.D. |
| Practice Address |
1336 Highway 54 W Bldg 200 Fayetteville GA 30214-4535 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7707169656 |
| Practice Fax Number | 7707161609 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2015-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 027370 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000439414E | 05 |
| Street Address |
1336 HIGHWAY 54 W BLDG 200 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891795407 | Tara Beth Gochenour | Specialist/Technologist | 1336 Highway 54 W, Bldg 500, Fayetteville, GA 30214-4535 | 2005-07-26 |
| 1679019020 | Kimberly Anne Wilmoth | Nurse Practitioner | 1336 Highway 54 W, Fayetteville, GA 30214-4535 | 2017-01-10 |
| 1538523964 | Christopher Bryan Bush | Nurse Practitioner | 1336 Highway 54 W, Bldg. 500, Fayetteville, GA 30214-4535 | 2016-04-12 |
| 1457630659 | Laura H Taylor | Specialist/Technologist | 1336 Highway 54 W, Bldg 500, Fayetteville, GA 30214-4535 | 2011-08-05 |
| 1407090459 | Edan Shapiro | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2009-04-21 |
| 1245473990 | Hagop Sarkissian | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2009-04-10 |
| 1124295357 | Amita Agarwal | Occupational Therapist | 1336 Highway 54 W, Fayetteville, GA 30214-4535 | 2008-05-16 |
| 1861679805 | John Thomas Abbott Jr. | Urology | 1336 Highway 54 W, Bldg 200, Fayetteville, GA 30214-4535 | 2008-01-22 |
| 1942426168 | Georgia Urology Pa | Urology | 1336 Highway 54 W, Building 200, Fayetteville, GA 30214-4535 | 2007-04-17 |
| 1649307885 | Resurgens, PC | Orthopaedic Surgery | 1336 Highway 54 W, Building 500, Fayetteville, GA 30214-4549 | 2007-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679581003 | Carolina Lithotripsy Ldt | Urology | 2014 Litho Place, Fayetteville, NC 28304 | 2006-08-03 |
| 1003873050 | Richard D Mcwhorter | Urology | 2 East Appleby Rd., Suite 201, Fayetteville, AR 72703 | 2006-04-26 |
| 1881656924 | Fayetteville Urology Associates Pa | Urology | 1786 Metromedical Drive, Fayetteville, NC 28304 | 2006-04-04 |
| 1801860630 | Philip R Kreitzer | Urology | 4211 Medical Center Dr, Suite 211, Fayetteville, NY 13066-6637 | 2006-02-16 |
| 1861476897 | Nirmal K Kilambi | Urology | 1300 E Zion Rd, Fayetteville, AR 72703-5015 | 2005-12-02 |
| 1013912369 | Albert Vazquez Lugo | Urology | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2005-06-14 |
| 1124022561 | Henry Edward Parfitt Jr. | Urology | 1786 Metromedical Dr, Fayetteville, NC 28304-3861 | 2005-06-13 |
| 1861026619 | Georgia Urology Piedmont, LLC | Urology | 1336 Highway 54 W Bldg 200, Fayetteville, GA 30214-4574 | 2020-03-02 |
| 1548755903 | Cumberland County Hospital System Inc | Urology | 1537 Owen Park Ln, Fayetteville, NC 28304-3454 | 2018-06-28 |
| 1295122315 | Mark William Pickhardt | Urology | 3232 N Northhills Blvd, Fayetteville, AR 72703-4005 | 2015-04-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on MR. FERNANDO A. DURALDE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.