MEDICARE: STEVEN M BERNSTEIN, MD, LLC

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	2085R0202X	Diagnostic Radiology Physician	37776	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BEBE1788	OTHER	CO	BCBS - GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588748099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN M BERNSTEIN, MD, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1129
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416-1129
Country	:	US
Telephone Number	:	970-874-2470
Fax Number	:	970-874-2475

Provider Business Practice Location Address
First Line	:	215 PARKSIDE DR
Second Line	:	SUITE 100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3131
Country	:	US
Telephone Number	:	719-471-7226
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	STEVEN M BERNSTEIN
Credential	:	MD
Telephone Number	:	970-874-2470

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	04/20/2008

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