Provider Demographics
NPI:1508825613
Name:BERNSTEIN, JEFFREY J (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:519 PINE TREE POINT RD
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:MD
Mailing Address - Zip Code:21561-1260
Mailing Address - Country:US
Mailing Address - Phone:301-387-0273
Mailing Address - Fax:301-387-0273
Practice Address - Street 1:1027 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-4343
Practice Address - Country:US
Practice Address - Phone:301-533-3300
Practice Address - Fax:301-533-3299
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25160207Q00000X
MDD31674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD531581600Medicaid
MDD75246Medicare UPIN
MDH822HX92Medicare ID - Type Unspecified