MEDICARE: ACV NEVADA BERNSTEIN PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1063047736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACV NEVADA BERNSTEIN PLLC

Provider Business Mailing Address
First Line	:	1525 E BELTLINE AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-4598
Country	:	US
Telephone Number	:	616-447-8220
Fax Number	:	616-710-4048

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST STE 170
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6325
Country	:	US
Telephone Number	:	702-878-8346
Fax Number	:	702-259-0205

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	VARICK BERNSTEIN
Credential	:	MD
Telephone Number	:	702-878-8346

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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