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NPI Code Detail

MEDICARE: DR. PAUL BERNABE M.D.

MEDICARE: DR. PAUL BERNABE M.D.
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
1207Q00000XFamily Medicine Physician118151MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00232368OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205835303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL BERNABE M.D.
Provider Business Mailing Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 304A E 4TH ST
Second Line :
City : ELDON
State : MO
Zip : 65026-1808
Country : US
Telephone Number : 573-392-5654
Fax Number : 573-392-5692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 05/05/2008

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Directions to “ DR. PAUL BERNABE M.D.” Practice Location

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