Individual
GARY B BERNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4157
Mailing address
429 COLLEGE AVE, HAVERFORD, PA 19041-1009
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
34994
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
G47355
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD019369E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005904350004
—
PA
01
—
022700
PA BCBS IND #
—
Enumeration date
06/16/2006
Last updated
09/17/2010
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