Individual
PAUL DAVID BERTOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
N9811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2834038-03
—
TX
05
—
2834038-04
—
TX
05
—
2834038-05
—
TX
01
—
N9811
TEXAS LICENSE
TX
01
—
P01473755
RAILROAD MEDICARE
TX
01
—
P01473765
RAILROAD MEDICARE
TX
Enumeration date
06/07/2011
Last updated
03/14/2016
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