Provider Demographics
NPI:1366400285
Name:BERNSTEIN, SCOTT L (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9458 E IRONWOOD SQUARE DR
Mailing Address - Street 2:SUTIE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4571
Mailing Address - Country:US
Mailing Address - Phone:480-767-7699
Mailing Address - Fax:480-767-7547
Practice Address - Street 1:9458 E IRONWOOD SQUARE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4571
Practice Address - Country:US
Practice Address - Phone:480-767-7699
Practice Address - Fax:480-767-7547
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24610207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG39453Medicare UPIN
AZ104605Medicare ID - Type UnspecifiedMEDICARE GRP