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General NPI Number Information
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NPI Number | 1174653554
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Entity Type | Individual
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Provider Name | HARRY N BERNARD D.P.M. LTD
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 34 GREEN NUMBER 4 DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-3336
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Country | US
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Telephone | 618-322-4579
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Fax | 636-947-5498
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Provider Business Mailing Address
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Address Line | 34 GREEN NUMBER 4 DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-3336
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Country | US
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Telephone | 618-322-4579
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Fax | 636-947-5498
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016002736
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License Number State | IL
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