Individual
DR. JACK MARK BERNSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3533 SOUTHERN BLVD STE 4200, KETTERING, OH 45429-1272
(937) 572-7648
(937) 832-8279
Mailing address
3533 SOUTHERN BLVD STE 4200, KETTERING, OH 45429-1272
(937) 572-7648
(937) 832-8279
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
35-055759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0438922
—
OH
Enumeration date
08/12/2005
Last updated
02/06/2019
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