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Dr. Michael Jerome Bernardo

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NPI Number Detailed Information

Provider Information:

Name: Dr. Michael Jerome Bernardo
Gender: M
Provider License Number If Given: 16266

NPI Information:

NPI: 1598764870
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 2/24/2015

Provider Business Mailing Address:

Address: 1109 WILSON ST
Newberry, SC 29108
Phone Number: 8033213035
Fax Number: 8033213034

Provider Business Practice Location Address:

Address: 1109 WILSON ST
Newberry, SC 29108
Phone Number: 8033213035
Fax Number: 8033213034

Provider Taxonomy:

Primary: 207Q00000X
Secondary (if any):
State: SC

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