Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 17450 | OK |
N | 111NI0900X | Internist | 17450 | OK |
Y | 207RG0300X | Geriatric Medicine | 17450 | OK |
NPI | 1043288970 |
---|---|
Provider Name | Marie A Bernard |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-5417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 03/07/2008 |