MEDICARE: DR. BERNARD N. STULBERG 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
1	174400000X	Specialist	35-04-5350	OH
2	207X00000X	Orthopaedic Surgery Physician	35045350	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F45350	OTHER	OH	SUMMA CARE
2	000000136997	OTHER	OH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0900366	OTHER	OH	UHC

General Provider Information

NPI Number	:	1538120738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARD N. STULBERG M.D.

Provider Business Mailing Address
First Line	:	PO BOX 932127
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0008
Country	:	US
Telephone Number	:	440-248-1297
Fax Number	:

Provider Business Practice Location Address
First Line	:	33001 SOLON RD
Second Line	:	SUITE 112
City	:	SOLON
State	:	OH
Zip	:	44139-2839
Country	:	US
Telephone Number	:	440-248-1297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	06/23/2021

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