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1073675740
JAXON JAMES FERNANDES
BELLEVILLE, NJ
NPI
1073675740
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NJ 25MA08153000)
Enumeration Date
2006-12-15
Last Update Date
2007-10-24
Business Address
-- JAXON JAMES FERNANDES MD
1 CLARA MAASS DR
BELLEVILLE, NJ 07109-3550
Phone number: 973-450-2000
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Mailing Address
-- JAXON JAMES FERNANDES MD
PO BOX 708640
SANDY, UT 84070-8640
Phone number: 866-869-2395
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