Individual
BERNARD L MARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3466
Mailing address
1499 WALTON WAY, AUGUSTA, GA 30901-2602
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
062741
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000437544B
—
GA
05
—
264760
—
SC
Enumeration date
05/23/2006
Last updated
11/30/2012
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