Provider Demographics
NPI:1730238064
Name:BERNARD, JOSEPH E (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:BERNARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G3169 BEECHER RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3611
Mailing Address - Country:US
Mailing Address - Phone:810-233-7228
Mailing Address - Fax:810-233-7255
Practice Address - Street 1:G3169 BEECHER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3611
Practice Address - Country:US
Practice Address - Phone:810-233-7228
Practice Address - Fax:810-233-7255
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJB008258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P45830OtherMEDICARE
MI0B51558OtherBLUE CROSS