Basic Information
| Provider Information | |||||||||
| NPI: | 1396035556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAWFIK | ||||||||
| FirstName: | BERNARD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 933 BRADBURY DR SE STE 2222 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871064375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052721320 | ||||||||
| FaxNumber: | 5052728060 | ||||||||
| Practice Location | |||||||||
| Address1: | UNM COMPREHENSIVE CANCER CENTER MSC07 4025 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724946 | ||||||||
| FaxNumber: | 5059250100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2011 | ||||||||
| LastUpdateDate: | 04/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Q3447 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | MD2018-0664 | NM | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207R00000X | MD2018-0664 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2014-00380 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1396035556 | 01 | NC | MEDCOST | OTHER | 1396035556 | 01 | NC | TRICARE | OTHER | 1869Z | 01 | NC | BCBS | OTHER | 1396035556 | 05 | NC | MEDICAID | 4873989 | 01 | NC | AETNA | OTHER | 5116058 | 01 | NC | UNITED HEALTHCARE | OTHER | Q80014 | 01 | NC | SC MEDICAID | OTHER | P01368327 | 01 | NC | RAILROAD MEDICARE | OTHER |