Provider Demographics
NPI:1306195300
Name:BERNTON, EDWARD W (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:W
Last Name:BERNTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 WISCONSIN CIR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7003
Mailing Address - Country:US
Mailing Address - Phone:240-920-8571
Mailing Address - Fax:240-235-1832
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:SUITE 700
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:240-920-8571
Practice Address - Fax:240-235-1832
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD14835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine