Provider Demographics
NPI:1851317622
Name:BERNAT, KARL R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:R
Last Name:BERNAT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4855
Mailing Address - Fax:919-620-4921
Practice Address - Street 1:3000 ROGERS RD STE 200
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5745
Practice Address - Country:US
Practice Address - Phone:919-385-3450
Practice Address - Fax:919-385-3499
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-02415207R00000X
NCNC20130214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016998890001Medicaid
PA0016998890001Medicaid
PA011791Medicare ID - Type Unspecified