Individual
GARY LEONARD BERNSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6628
Mailing address
PO BOX 1154, NEWNAN, GA 30264-1154
(404) 273-8771
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
030269
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000475065C
—
GA
01
—
52025542003
BLUE CROSS BLUE SHIELD
GA
01
—
P00168410
RAILROAD MEDICARE
GA
Enumeration date
08/14/2006
Last updated
04/27/2021
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