Provider Demographics
NPI:1477848935
Name:BERNHARD, ANDREA MARCELLA (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARCELLA
Last Name:BERNHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61-278 KAMEHAMEHA HWY
Mailing Address - Street 2:#4
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-1326
Mailing Address - Country:US
Mailing Address - Phone:361-212-5854
Mailing Address - Fax:
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:361-212-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17591208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist