MEDICARE: DR. LAWRENCE D BERNSTEIN 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	207R00000X	Internal Medicine Physician	01027640	IN
2	207R00000X	Internal Medicine Physician	01027640A	IN

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

General Provider Information

NPI Number	:	1770586661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE D BERNSTEIN MD

Provider Business Mailing Address
First Line	:	9122 COLUMBIA AVENUE
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-2907
Country	:	US
Telephone Number	:	219-836-3366
Fax Number	:	219-836-3559

Provider Business Practice Location Address
First Line	:	9122 COLUMBIA AVENUE
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-2901
Country	:	US
Telephone Number	:	219-836-3366
Fax Number	:	219-836-3559

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/13/2010

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