Healthcare Provider Details

I. General information

NPI: 1851030878
Provider Name (Legal Business Name): CAMERON BERNATH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 W 30TH ST
CLEVELAND OH
44113-3401
US

IV. Provider business mailing address

19875 CENTER RIDGE RD APT 275
ROCKY RIVER OH
44116-3643
US

V. Phone/Fax

Practice location:
  • Phone: 419-304-5315
  • Fax:
Mailing address:
  • Phone: 419-304-5315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT006986
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: