Provider Demographics
NPI:1114914520
Name:BERNARD, PIERRE RENE' (DO)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:RENE'
Last Name:BERNARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-382-5471
Mailing Address - Fax:515-382-5621
Practice Address - Street 1:230 SOUTH 6TH STREET
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-2534
Practice Address - Country:US
Practice Address - Phone:515-382-5471
Practice Address - Fax:515-382-5621
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4160846Medicaid
IAI21714Medicare PIN
IA4160846Medicaid