Provider Demographics
NPI:1073637997
Name:BERNIER, BARRE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRE
Middle Name:
Last Name:BERNIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 MCLEOD DR
Mailing Address - Street 2:CAMBRIDGE WPR, SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2257
Mailing Address - Country:US
Mailing Address - Phone:702-871-8535
Mailing Address - Fax:
Practice Address - Street 1:5850 EUBANK BLVD NE
Practice Address - Street 2:MTN RUN B-49 STE 202
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-6132
Practice Address - Country:US
Practice Address - Phone:505-379-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM84-9207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A16942Medicare UPIN