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NPI Code Detail

MEDICARE: MICHAEL LYN BERNSTEIN M.D., PHD

MEDICARE: MICHAEL LYN BERNSTEIN M.D., PHD
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
1208200000XPlastic Surgery Physician2009009423MO

General Provider Information

NPI Number : 1679695977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LYN BERNSTEIN M.D., PHD
Provider Business Mailing Address
First Line : 1008 S SPRING AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2520
Country : US
Telephone Number : 314-977-4722
Fax Number : 314-977-1877
Provider Business Practice Location Address
First Line : 1008 S SPRING AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2520
Country : US
Telephone Number : 314-577-8793
Fax Number : 314-268-5062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 03/14/2025

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