Healthcare Provider Details

I. General information

NPI: 1750367405
Provider Name (Legal Business Name): NEWBERRY FAMILY HEALTH CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 HARRINGTON ST STE 1
NEWBERRY SC
29108-3088
US

IV. Provider business mailing address

1109 WILSON ST
NEWBERRY SC
29108-3443
US

V. Phone/Fax

Practice location:
  • Phone: 803-321-3035
  • Fax: 803-321-3034
Mailing address:
  • Phone: 803-321-3035
  • Fax: 803-321-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J BERNARDO
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 803-924-1152