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NPI Code Detail

MEDICARE: DR. DARLY M BERNARDO MD

MEDICARE:  DR. DARLY M BERNARDO  MD
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 Physician16288SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
29337OTHERSCMEDICARE PTAN

Other Identifiers

General Provider Information

NPI Number : 1760481055
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARLY M BERNARDO MD
Provider Business Mailing Address
First Line : 5500 MARYLAND WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4948
Country : US
Telephone Number : 888-830-4255
Fax Number :
Provider Business Practice Location Address
First Line : 517 PUCKETT FERRY RD
Second Line :
City : GREENWOOD
State : SC
Zip : 29649-8698
Country : US
Telephone Number : 864-388-4325
Fax Number : 864-388-4327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 11/17/2015

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Directions to “ DR. DARLY M BERNARDO MD” Practice Location

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