Healthcare Provider Details

I. General information

NPI: 1598081390
Provider Name (Legal Business Name): DAVID BERNSTEIN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NE RIDDELL RD
BREMERTON WA
98310-3037
US

IV. Provider business mailing address

PO BOX 879
PORT ORCHARD WA
98366
US

V. Phone/Fax

Practice location:
  • Phone: 360-850-4321
  • Fax:
Mailing address:
  • Phone: 360-850-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number442
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number442
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number442
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number442
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number442
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number442
License Number StateWA
# 7
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number442
License Number StateWA

VIII. Authorized Official

Name: DR. DAVID M BERNSTEIN
Title or Position: OWNER
Credential: DPM
Phone: 360-850-4321