Individual
DEAN H BERNACCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4366 LAKEVIEW GLEN DRIVE, MEDINA, OH 44256-6513
(330) 721-2774
Mailing address
4366 LAKEVIEW GLEN DRIVE, MEDINA, OH 44256-6513
(330) 721-2774
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35025014B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406868
—
OH
Enumeration date
05/07/2007
Last updated
07/08/2007
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