Provider Demographics
NPI:1598806069
Name:BERNSTEIN, MICHAEL PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:510 ROUTES 6 AND 209
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-9490
Mailing Address - Country:US
Mailing Address - Phone:570-296-9296
Mailing Address - Fax:570-296-2158
Practice Address - Street 1:510 ROUTES 6 AND 209
Practice Address - Street 2:SUITE 202
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-7615
Practice Address - Country:US
Practice Address - Phone:570-296-9296
Practice Address - Fax:570-296-2158
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003820L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA749584OtherMEDICARE
NJ472147OtherMEDICARE
PAU47197Medicare UPIN