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General NPI Number Information
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NPI Number | 1265467559
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Entity Type | Individual
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Provider Name | MARK E BERNDT MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 1447 N HARRISON ST
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City | SAGINAW
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State | MI
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Zip | 48602-4727
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Country | US
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Telephone | 989-583-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98978
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City | LAS VEGAS
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State | NV
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Zip | 89193-8978
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 16573
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301068879
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License Number State | MI
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