Healthcare Provider Details

I. General information

NPI: 1841276532
Provider Name (Legal Business Name): BERNARD S LOFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6149 N WAYNE RD
WESTLAND MI
48185-7128
US

IV. Provider business mailing address

6149 N WAYNE RD
WESTLAND MI
48185-7128
US

V. Phone/Fax

Practice location:
  • Phone: 734-728-2130
  • Fax: 734-728-2626
Mailing address:
  • Phone: 734-728-2130
  • Fax: 734-728-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101005503
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: