Provider Demographics
NPI:1215193875
Name:BERNHARDT, LOUIS C (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:C
Last Name:BERNHARDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2711 ALLEN BLVD STE 300
Mailing Address - Street 2:DEAN FOUNDATION - BSP FREE CLINIC
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2287
Mailing Address - Country:US
Mailing Address - Phone:608-827-2300
Mailing Address - Fax:608-827-2399
Practice Address - Street 1:2711 ALLEN BLVD STE 300
Practice Address - Street 2:DEAN FOUNDATION - BSP FREE CLINIC
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2287
Practice Address - Country:US
Practice Address - Phone:608-827-2308
Practice Address - Fax:608-827-2344
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI14974208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery