Healthcare Provider Details

I. General information

NPI: 1538108212
Provider Name (Legal Business Name): RICHARD H. BERNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 FERRY RD
CHARLOTTE VT
05445-9555
US

IV. Provider business mailing address

PO BOX 38
CHARLOTTE VT
05445-0038
US

V. Phone/Fax

Practice location:
  • Phone: 802-425-2781
  • Fax:
Mailing address:
  • Phone: 802-425-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberVT4983
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: