Provider Demographics
NPI:1255329165
Name:DUESLER, BERNICE G (MD)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:G
Last Name:DUESLER
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9234
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:1648 HUNTINGDON PIKE
Practice Address - Street 2:CHOP CARE NETWORK AT HOLY REDEEMER HOSPITAL
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8001
Practice Address - Country:US
Practice Address - Phone:215-938-2903
Practice Address - Fax:215-938-2905
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-050708-L208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016603470001Medicaid
003519EF8Medicare ID - Type Unspecified
PA0016603470001Medicaid