Healthcare Provider Details

I. General information

NPI: 1871704593
Provider Name (Legal Business Name): HENRI SIEGFRIED BERNARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 W BLOOMFIELD LAKE RD
WEST BLOOMFIELD MI
48323-2411
US

IV. Provider business mailing address

5321 W BLOOMFIELD LAKE RD
WEST BLOOMFIELD MI
48323-2411
US

V. Phone/Fax

Practice location:
  • Phone: 248-481-9790
  • Fax: 248-481-9790
Mailing address:
  • Phone: 248-481-9790
  • Fax: 248-481-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301025888
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: