Individual
DR. JOHNATHAN ALEXANDER BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
24600 MILLSTREAM DRIVE, SUITE 380, ALDIE, VA 20105-5686
(703) 810-5241
(571) 407-5689
Mailing address
PO BOX 75868, BALTIMORE, MD 21275-4095
(703) 810-5204
(703) 810-5411
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101258391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
UNLICENSED MEDICAL PRACITIONER
MD
Enumeration date
07/02/2009
Last updated
11/10/2020
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