MEDICARE: EVENTURE DULDULAO BERNARDINO MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301068741	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	080179045	OTHER		RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080G310660	OTHER	MI	BCBS
2	0985019	OTHER		HEALTHPLUS OF MICHIGAN
3	1010674	OTHER		MCLAREN HEALTH PLAN
4	1010674	OTHER		HEALTH ADVANTAGE PPO
5	11812	OTHER		GREAT LAKES HEALTH PLAN
6	159	OTHER	MI	COMMUNITY CHOICE
7	5128736	OTHER		AETNA
8	P101711	OTHER		BLUE CARE NETWORK OF MICH
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	381908328	OTHER		UNDER
12	4336750	OTHER		MOLINA HEALTH CARE OF MIC
13	381908328	OTHER		HCAP
14	381908328	OTHER		FIRST HEALTH
15	381908328	OTHER		PPOM
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1447248232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVENTURE DULDULAO BERNARDINO MD

Provider Business Mailing Address
First Line	:	501 LAPEER
Second Line	:	HEALTH DELIVERY INC
City	:	SAGINAW
State	:	MI
Zip	:	48607-1208
Country	:	US
Telephone Number	:	989-759-6464
Fax Number	:	989-399-8233

Provider Business Practice Location Address
First Line	:	6297 DIXIE HWY
Second Line	:
City	:	BRIDGEPORT
State	:	MI
Zip	:	48722-9635
Country	:	US
Telephone Number	:	989-759-6460
Fax Number	:	989-759-6465

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	04/08/2021