Provider Demographics
NPI:1932182029
Name:BERNSTEIN, RICK V (MD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:V
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 1:1525 E BELTLINE AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-4598
Mailing Address - Country:US
Mailing Address - Phone:616-447-8220
Mailing Address - Fax:616-710-4048
Practice Address - Street 1:4275 BURNHAM AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5495
Practice Address - Country:US
Practice Address - Phone:702-878-8346
Practice Address - Fax:705-259-0205
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301116731208G00000X
NV10435208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500467Medicaid
NV100500467Medicaid
D16515Medicare UPIN