Provider Demographics
NPI:1932597358
Name:BERNARD, MARET ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:MARET
Middle Name:ELIZABETH
Last Name:BERNARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 OAK ST
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1032
Mailing Address - Country:US
Mailing Address - Phone:412-877-9108
Mailing Address - Fax:
Practice Address - Street 1:308 BESSEMER RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-9134
Practice Address - Country:US
Practice Address - Phone:724-542-4321
Practice Address - Fax:724-542-4298
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA0573252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant