Provider Demographics
NPI:1467480228
Name:BERNSTEIN, JONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JONNA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JONNA
Other - Middle Name:
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5945 HABERSHAM DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6337
Mailing Address - Country:US
Mailing Address - Phone:919-619-8836
Mailing Address - Fax:
Practice Address - Street 1:3310 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115
Practice Address - Country:US
Practice Address - Phone:803-531-6900
Practice Address - Fax:803-531-6907
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891351JMedicaid
NC58-2569828OtherUNITED HEALTHCARE
NC7453359OtherAETNA
NC7453359OtherAETNA
NC58-2569828OtherUNITED HEALTHCARE