Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 35066125B | OH |
Y | 207RP1001X | Pulmonary Disease | 35066125B | OH |
N | 207RS0012X | Sleep Medicine | 35066125 | OH |
NPI | 1073595203 |
---|---|
Provider Name | Dean Manuel Bernardo |
First Address | Maumee, OH 43537 |
Second Address | Maumee, OH 43537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 08/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0956023 | (05) | OH |
290010946 | MEDICARE RAILRAOD (01) | OH |
F78296 | (02) | OH |