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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1770056400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL INNOVATIONS CONCEPTS, P.C.

Provider Business Mailing Address
First Line	:	560 CROFTON PARK LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-6516
Country	:	US
Telephone Number	:	423-741-0191
Fax Number	:

Provider Business Practice Location Address
First Line	:	1908 CAUDLE DR STE 100
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-4322
Country	:	US
Telephone Number	:	704-890-8080
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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