Individual
DR. MATTHEW DONALD BERNENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 GRESHAM DR STE 8630, NORFOLK, VA 23507-1904
(757) 388-6115
Mailing address
PO BOX 936, EVMS MEDICAL GROUP, NORFOLK, VA 23501-0936
(757) 446-8920
(757) 446-5242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101255467
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101255467
VA
207RP1001X
Pulmonary Disease Physician
Primary
0101255467
VA
390200000X
Student in an Organized Health Care Education/Training Program
0101255467
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-028
TRICARE/CHAMPUS
VA
01
—
10130540
OPTIMA HEALTH
VA
01
—
1083913339
COVENTRY NETWORK
VA
05
—
1083913339
—
NC
05
—
1083913339
—
VA
01
—
520691
ANTHEM BC/BS
VA
01
—
PAR
VIRGINIA HEALTH NETWORK
VA
Enumeration date
03/24/2011
Last updated
06/29/2018
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