Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 165085-1205 | UT |
N | 207VE0102X | Reproductive Endocrinologist | 27121 | NC |
Y | 207VE0102X | Reproductive Endocrinologist | ME47242 | FL |
NPI | 1528053667 |
---|---|
Provider Name | Marc A Bernhisel |
First Address | Tampa, FL 33617-1126 |
Second Address | Tampa, FL 33617-1126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C82805 | (02) |