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General NPI Number Information
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NPI Number | 1902858574
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Entity Type | Individual
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Provider Name | MICHAEL R. BERNUI D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 353 NEW SHACKLE ISLAND RD SUITE 207-A
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2379
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Country | US
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Telephone | 615-338-0123
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Fax | 615-338-0553
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Provider Business Mailing Address
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Address Line | 353 NEW SHACKLE ISLAND RD SUITE 207-A
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2379
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Country | US
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Telephone | 615-338-0123
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Fax | 615-338-0553
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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 | DO0000000813
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License Number State | TN
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