Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2019-01278 | NC |
N | 2086S0105X | Surgery of the Hand | MT214812 | PA |
NPI | 1538504030 |
---|---|
Provider Name | Derek Thomas Bernstein |
First Address | Charlotte, NC 28260-0447 |
Second Address | Winston Salem, NC 27106-5471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2013 |
Last Update Date | 26/10/2020 |