Provider Demographics
NPI:1578700829
Name:MASTER, BERNARD F (DO)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:F
Last Name:MASTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3030
Mailing Address - Country:US
Mailing Address - Phone:614-888-2575
Mailing Address - Fax:614-888-2575
Practice Address - Street 1:340 TUCKER DR
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3030
Practice Address - Country:US
Practice Address - Phone:614-888-2575
Practice Address - Fax:614-888-2575
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine