Provider Demographics
NPI:1447248232
Name:BERNARDINO, EVENTURE DULDULAO (MD)
Entity type:Individual
Prefix:
First Name:EVENTURE
Middle Name:DULDULAO
Last Name:BERNARDINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 LAPEER
Mailing Address - Street 2:HEALTH DELIVERY INC
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:6297 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:MI
Practice Address - Zip Code:48722-9635
Practice Address - Country:US
Practice Address - Phone:989-759-6460
Practice Address - Fax:989-759-6465
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2021-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301068741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080G310660OtherBCBS
0985019OtherHEALTHPLUS OF MICHIGAN
1010674OtherMCLAREN HEALTH PLAN
1010674OtherHEALTH ADVANTAGE PPO
11812OtherGREAT LAKES HEALTH PLAN
MI159OtherCOMMUNITY CHOICE
5128736OtherAETNA
P101711OtherBLUE CARE NETWORK OF MICH
080179045OtherRAILROAD MEDICARE
MI1447248232Medicaid
381908328OtherUNDER
4336750OtherMOLINA HEALTH CARE OF MIC
381908328OtherHCAP
381908328OtherFIRST HEALTH
381908328OtherPPOM
MI4336750Medicaid
MI159OtherCOMMUNITY CHOICE
381908328OtherHCAP