Guillermo Bernal, MD
Organization Active NPI Specialist · Laurel, DE
NPI 1184649477 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1184649477
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- C10001671 (DE)
- Legal business name
- GUILLERMO BERNAL, MD
- Practice address
- 405 N Central Ave Ste a
Laurel, DE 19956-1104 - Phone
- (302) 875-9355
- NPI assigned
- Jul 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Guillermo Bernal, MD
- Title
- Owner
- Phone
- (302) 875-9355
National Provider Directory
Locations
405 N Central Ave
Ste A
Laurel, DE 19956
Phone (302) 875-9355
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | C10001671 | DE | Yes |
Addresses
Primary practice location
405 N Central Ave Ste a
Laurel, DE 19956-1104
Mailing address
646 N Dual Hwy
Seaford, DE 19973-1756
Phone (302) 628-2687
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000186501 | Medicaid | DE |
Other providers in Laurel, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.