MEDICARE: RICHARD A BERNERT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	31463	AZ

General Provider Information

NPI Number	:	1013997832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A BERNERT MD

Provider Business Mailing Address
First Line	:	9060 E VIA LINDA # 9098
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5422
Country	:	US
Telephone Number	:	480-275-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	9060 E VIA LINDA # 9098
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5422
Country	:	US
Telephone Number	:	480-275-2494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	12/02/2014

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