MEDICARE: UDELL BERNSTEIN MD PC

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	207V00000X	Obstetrics & Gynecology Physician	16211	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160016524	OTHER	CO	RRW MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447433354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UDELL BERNSTEIN MD PC

Provider Business Mailing Address
First Line	:	1295 COLORADO BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3615
Country	:	US
Telephone Number	:	303-355-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1295 COLORADO BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3615
Country	:	US
Telephone Number	:	303-355-7650
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. UDELL L BERNSTEIN
Credential	:	MD
Telephone Number	:	303-355-7650

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	05/01/2008

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