NPI 1265094239 · live from the CMS NPI Registry
Samuel Bernard, DPM
Podiatrist, Foot & Ankle Surgery in Waterloo, IA. National Provider Identifier 1265094239, active.
NPI record
| NPI | 1265094239 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 3421 W 9th St, Waterloo, IA 50702 |
| Practice phone | 319-272-0284 |
| Mailing address | 949 Fletcher Ave, Waterloo, IA 50701 |
| Enumerated | July 1, 2019 |
| Last updated | July 1, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 097054 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.