MEDICARE: DR. BERNARD T BARTOLOME M.D.

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	6780	NV

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	:	1811958341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARD T BARTOLOME M.D.

Provider Business Mailing Address
First Line	:	PO BOX 80985
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89180-0985
Country	:	US
Telephone Number	:	702-256-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	4180 S RAINBOW BLVD
Second Line	:	STE 809
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3135
Country	:	US
Telephone Number	:	702-256-3637
Fax Number	:	702-633-4341

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

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	11/16/2023

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