Individual
KEITH BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2875 S 171ST ST, NEW BERLIN, WI 53151-3511
(262) 786-3107
(262) 780-0442
Mailing address
2875 S 171ST ST, NEW BERLIN, WI 53151-3511
(262) 786-3107
(262) 780-0442
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
27436
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31511600
—
WI
Enumeration date
07/26/2006
Last updated
07/08/2007
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