MEDICARE: MEDICAL INNOVATIONS CONCEPTS, P.C.

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	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1518438811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL INNOVATIONS CONCEPTS, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 305172
Second Line	:	DEPT 145
City	:	NASHVILLE
State	:	TN
Zip	:	37230-5172
Country	:	US
Telephone Number	:	423-741-0191
Fax Number	:

Provider Business Practice Location Address
First Line	:	294 N NC 16 BUSINESS HWY STE B
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8741
Country	:	US
Telephone Number	:	704-483-8105
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND SECRETARY
Name	:	DR. DANIEL BERNSTEIN
Credential	:	MD
Telephone Number	:	704-890-8080

Provider Enumeration Date	:	12/12/2018
Last Update Date	:	04/24/2019

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