MEDICARE: ERIC A BERNAUER 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	207L00000X	Anesthesiology Physician	32988	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	050044649	OTHER		RR MEDICARE
4	CH6461	OTHER		RR MEDICARE - GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	PH18408	OTHER		BCBS

General Provider Information

NPI Number	:	1053370429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC A BERNAUER MD

Provider Business Mailing Address
First Line	:	PO BOX 570
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81002-0570
Country	:	US
Telephone Number	:	719-296-5841
Fax Number	:	719-542-0746

Provider Business Practice Location Address
First Line	:	916 INDIANA AVE STE 120
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81004-3572
Country	:	US
Telephone Number	:	719-296-5841
Fax Number	:	719-542-0746

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	04/30/2019

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Directions to “ ERIC A BERNAUER MD” Practice Location

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