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General NPI Number Information
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NPI Number | 1073993150
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Entity Type | Organization
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Legal Business Name | ANNETTE MARY BERNARD MD P.A.
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 2470 WINDY HILL RD SE NUM 366C
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 404-414-2523
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Fax | 404-393-8880
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Provider Business Mailing Address
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Address Line | 2470 WINDY HILL RD SE NUM 366C
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 404-414-2523
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Fax | 404-393-8880
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANNETTE MARY BERNARD
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Credential | M.D.
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Telephone | 404-414-2523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | GA
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