Provider Demographics
NPI:1386633949
Name:BERNARD, MICHAEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:BERNARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 NIGHTINGALE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2754
Mailing Address - Country:US
Mailing Address - Phone:865-632-5885
Mailing Address - Fax:865-632-5893
Practice Address - Street 1:6600 NIGHTINGALE LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2754
Practice Address - Country:US
Practice Address - Phone:865-632-5885
Practice Address - Fax:865-632-5893
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD28065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4119668OtherBLUE CROSS
TN3803168Medicaid
TNTN0108OtherJOHN DEERE
TN204124194OtherTAX ID NUMBER
TN204124194OtherTAX ID NUMBER
TN4119668OtherBLUE CROSS