Provider Demographics
NPI:1366788846
Name:BACEVICH, BERNARD BRON (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:BRON
Last Name:BACEVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HILLTOP LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4121
Mailing Address - Country:US
Mailing Address - Phone:513-236-4524
Mailing Address - Fax:513-521-2448
Practice Address - Street 1:225 HILLTOP LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-4121
Practice Address - Country:US
Practice Address - Phone:513-236-4524
Practice Address - Fax:513-521-2448
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 030270207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery