Provider Demographics
NPI:1083624464
Name:SCOTT L BERNSTEIN, MD, PC
Entity Type:Organization
Organization Name:SCOTT L BERNSTEIN, MD, PC
Other - Org Name:INTERNAL MEDICINE & GERIATRIC MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-767-7699
Mailing Address - Street 1:9458 E IRONWOOD SQUARE DR
Mailing Address - Street 2:STE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4571
Mailing Address - Country:US
Mailing Address - Phone:480-767-7699
Mailing Address - Fax:480-767-7547
Practice Address - Street 1:9458 E IRONWOOD SQUARE DR
Practice Address - Street 2:STE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4571
Practice Address - Country:US
Practice Address - Phone:480-767-7699
Practice Address - Fax:480-767-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24610207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG39453Medicare UPIN
AZ27252Medicare ID - Type UnspecifiedMEDICARE