Marylou David Fernando, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

028770 Issued in GA

Practice address

1113 Garredd Blvd Ste B
Augusta, GA 30909-6757

Phone

(706) 364-8220

Fax

(706) 922-5856

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: marylou.fernando@gadirect.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1881644045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 GOLDEN CAMP RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065515",
            "telephone_number": "706-790-4440",
            "fax_number": "706-790-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 GARREDD BLVD STE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096757",
            "telephone_number": "706-364-8220",
            "fax_number": "706-922-5856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Garredd Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096751",
            "country_code": "US",
            "telephone_number": "706-863-5776",
            "fax_number": "706-868-7057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "MARYLOU",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "028770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00344132H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Lee Ferguson III, DMD
• Ana R Fernandes Longuino, M.D.
• Andrea Fernandez
• Elva Elizabeth Fernandez, M.D.
• Mara Lynne Fernandez, RN
• Rachele Ferons
• Kinga Kovacs Ferrara, M.D.
• Lynley Taylor Ferrell
• Michelle Ferrell, PSYD
• Daron G. Ferris, MD

• Pediatrics Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.