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Organization
SCOTT W BERNEBURG DPM INC
Active
Organization
SCOTT W BERNEBURG DPM INC
Active
Other names
Beckley Foot & Ankle Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT WILLIAM BERNEBURG DPM (PRESIDENT OWNER)
(304) 253-9895
Entity
Organization
Contact information
Practice address
315 HARPER PARK DR, BECKLEY, WV 25801-2617
(304) 253-9895
(304) 253-9896
Mailing address
315 HARPER PARK DR, BECKLEY, WV 25801-2617
(304) 253-9895
(304) 253-9896
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00325
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706128
MOUNTAIN STATE BC BS
WV
01
—
DG1411
RAILROAD MEDICARE
WA
Enumeration date
12/29/2005
Last updated
09/29/2008
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