Provider Demographics
NPI:1467522185
Name:ELMA Z BERNARDO MD AND ASSOCIATES INC
Entity Type:Organization
Organization Name:ELMA Z BERNARDO MD AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMA
Authorized Official - Middle Name:ZAPANTA
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-766-3470
Mailing Address - Street 1:401 DIVISION ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1455
Mailing Address - Country:US
Mailing Address - Phone:304-766-3470
Mailing Address - Fax:304-766-3494
Practice Address - Street 1:401 DIVISION ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1455
Practice Address - Country:US
Practice Address - Phone:304-766-3470
Practice Address - Fax:304-766-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV123942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1042627OtherWORKERS COMPENSATION
WV15852889300OtherAVTAL OF OHIO
WV0116974001Medicaid
WVCG8650OtherMEDICARE TYPE UNSPECIFIED
WV0116974001Medicaid
WV9297261Medicare PIN