Provider Demographics
NPI:1114941036
Name:NAGEL, BERNARD MICHAEL JR (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:MICHAEL
Last Name:NAGEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:NAGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:90 TER HEUN DR
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2533
Mailing Address - Country:US
Mailing Address - Phone:508-457-0088
Mailing Address - Fax:508-540-9613
Practice Address - Street 1:90 TER HEUN DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2533
Practice Address - Country:US
Practice Address - Phone:508-457-0088
Practice Address - Fax:508-540-9613
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265335207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D16556Medicare UPIN