Provider Demographics
NPI:1477871929
Name:BERNARD, CAITLIN (MD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 N UNIVERSITY BLVD UH 2440
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1402
Practice Address - Country:US
Practice Address - Phone:317-944-8231
Practice Address - Fax:317-944-7417
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015015484207V00000X
IN01078719A207VC0300X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family Planning
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300005809Medicaid
IN000001103915OtherANTHEM PTAN