Basic Information
| Provider Information | |||||||||
| NPI: | 1861497422 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERNSTEIN | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12510 PROSPERITY DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209041663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404855200 | ||||||||
| FaxNumber: | 3016256906 | ||||||||
| Practice Location | |||||||||
| Address1: | 7350 VAN DUSEN RD | ||||||||
| Address2: | STE 210 | ||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207075268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014985500 | ||||||||
| FaxNumber: | 3014987346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | D0038451 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | N5630032 | 01 | MD | CAREFIRST MD/DC | OTHER | A1110006 | 01 | DC | CAREFIRST BCBS DC | OTHER | P00703863 | 01 | ME | RAILROAD MEDICARE | OTHER | 110067644 | 01 | MD | RAILROAD MEDICARE | OTHER | 2516-0005 | 01 | DC | CAREFIRST BSDC | OTHER | 530681700 | 05 | MD | MEDICAID | A1130007 | 01 | DC | CAREFIRST BCBS DC | OTHER | 604860-01 | 01 | MD | CAREFIRST BSMD | OTHER |