Individual
DIANE BERNARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5750 FALLS DR, FORT WAYNE, IN 46804-7147
(260) 436-8000
(260) 432-5587
Mailing address
5750 FALLS DR, FORT WAYNE, IN 46804-7147
(260) 436-8000
(260) 432-5587
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01052974A
IN
207N00000X
Dermatology Physician
3568238
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015104
RAILROAD
OH
05
—
138621
—
OH
Enumeration date
03/14/2007
Last updated
03/26/2014
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