Provider Demographics
NPI:1538120738
Name:STULBERG, BERNARD N (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:N
Last Name:STULBERG
Suffix:
Gender:M
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:PO BOX 932127
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0008
Mailing Address - Country:US
Mailing Address - Phone:440-248-1297
Mailing Address - Fax:
Practice Address - Street 1:33001 SOLON RD
Practice Address - Street 2:SUITE 112
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2839
Practice Address - Country:US
Practice Address - Phone:440-248-1297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-5350174400000X
OH35045350207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF45350OtherSUMMA CARE
OH000000136997OtherANTHEM
OH0445665Medicaid
OH0900366OtherUHC
OHST0481354Medicare PIN
OH0900366OtherUHC
OH200012780Medicare PIN
OH0445665Medicaid
OHH387140Medicare PIN