| Doctor Name: | DR. WILFRIDO D BERNARDO |
| NPI Number: | 1003801887 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 11479 |
| Business Practice Address: | 130 Lebanon Hwy Suite B Carthage, TN - 370302955 |
| Business Phone Number: | 6157350700 |
| Business Fax Number: | 6157355451 |
| Mailing Address: | Po Box 176, CARTHAGE |
| State: | TN |
| Postal Code: | 370300176 |
| Phone Number: | 6157350700 |
| Fax Number: | 6157355451 |
| NPI Enumeration Date: | 09/16/2005 |
| NPI Last Update Date: | 03/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11479 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |