Provider Demographics
NPI:1659471241
Name:RICHARD A BERNSTEIN MD PA
Entity Type:Organization
Organization Name:RICHARD A BERNSTEIN MD PA
Other - Org Name:ANNAPOLIS ALLERGY & HEALTH ENHANCEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-224-5558
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7098
Mailing Address - Country:US
Mailing Address - Phone:410-224-5558
Mailing Address - Fax:410-224-7321
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 109
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-224-5558
Practice Address - Fax:410-224-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033069207R00000X, 207RA0201X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD042MMedicare ID - Type Unspecified
MDD76856Medicare UPIN