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Individual

MAURICE R BERNAICHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
500 GORDON AVE, THOMASVILLE, GA 31792-6646
(850) 765-8623
Mailing address
1401 OVEN PARK DR STE 201, TALLAHASSEE, FL 32308-7958
(850) 765-8623

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
54547
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
54547
GA
208VP0014X
Interventional Pain Medicine Physician
OS20454
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000032786
BMC
MA
01
226816
CONNECTICARE
MA
01
37645
HEALTH NEW ENGLAND
MA
01
478927
TUFTS
MA
01
7421780
AETNA
MA
01
8900941
CIGNA
MA
01
AA53780
HARVARD PILGRIM
MA
01
J29800
BCBS MA
MA
Enumeration date
03/14/2006
Last updated
12/26/2023
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