Individual
JOHN A BERNEIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 E 3900 S, SUITE 260, SALT LAKE CITY, UT 84124-1348
(801) 265-2000
(801) 265-2008
Mailing address
1250 E 3900 S, SUITE 260, SALT LAKE CITY, UT 84124-1348
(801) 265-2000
(801) 265-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3645941205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870617263004/D2710
—
UT
Enumeration date
11/30/2005
Last updated
06/07/2021
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