MEDICARE: DR. STEVEN W BERNSTORF O.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	152W00000X	Optometrist	1278	NC

General Provider Information

NPI Number	:	1740282219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN W BERNSTORF O.D.

Provider Business Mailing Address
First Line	:	2633 RANDLEMAN RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-5107
Country	:	US
Telephone Number	:	336-274-2222
Fax Number	:	336-274-2228

Provider Business Practice Location Address
First Line	:	2633 RANDLEMAN RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-5107
Country	:	US
Telephone Number	:	336-274-2222
Fax Number	:	336-274-2228

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	06/30/2010

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