Provider Demographics
NPI:1477544450
Name:BERNSTEIN, STEPHEN ADAM (MD, MPH, FAAFP)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ADAM
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD, MPH, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 DAPHNE DR
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-7863
Mailing Address - Country:US
Mailing Address - Phone:334-722-1350
Mailing Address - Fax:
Practice Address - Street 1:301 ANDREWS AVENUE
Practice Address - Street 2:LYSTER ARMY HEALTH CLINIC
Practice Address - City:FORT RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362
Practice Address - Country:US
Practice Address - Phone:334-255-7387
Practice Address - Fax:334-255-7716
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL236462083A0100X, 207Q00000X
FLME74643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine