Healthcare Provider Details

I. General information

NPI: 1992792907
Provider Name (Legal Business Name): RENALD M. BERNARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DUFF AVENUE MCFARLAND CLINIC PC
AMES IA
50010-3014
US

IV. Provider business mailing address

PO BOX 3014 1215 DUFF AVE MCFARLAND CLINIC, PC
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4400
  • Fax: 515-239-4446
Mailing address:
  • Phone: 515-239-4400
  • Fax: 515-239-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23450
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number23450
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: