Provider Demographics
NPI:1861417610
Name:BERNARDONI, ROBERT JAMES (M D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:BERNARDONI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53530-0153
Mailing Address - Country:US
Mailing Address - Phone:608-776-2718
Mailing Address - Fax:608-776-2718
Practice Address - Street 1:731 CLAY ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53530-1225
Practice Address - Country:US
Practice Address - Phone:608-776-4497
Practice Address - Fax:608-776-2317
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI22260-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B51524Medicare UPIN