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General NPI Number Information
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NPI Number | 1225386824
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Entity Type | Individual
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Provider Name | ANDREW BERNSTEIN
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Gender | Male
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1255 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4526
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Country | US
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Telephone | 770-719-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4526
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Country | US
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Telephone | 770-362-0984
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 82630
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA12139100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 82630
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 334634
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD485881
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License Number State | PA
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