Healthcare Provider Details

I. General information

NPI: 1558813964
Provider Name (Legal Business Name): STEVEN BERNING MS, AT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 N HEWITT RD
YPSILANTI MI
48197-1701
US

IV. Provider business mailing address

681 MILFORD FARMS CT
MILFORD MI
48381-3353
US

V. Phone/Fax

Practice location:
  • Phone: 734-487-9956
  • Fax:
Mailing address:
  • Phone: 419-708-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number2601001382
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: