Provider Demographics
NPI:1245234814
Name:BERNING, LENORA W (MD)
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:W
Last Name:BERNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2408
Mailing Address - Country:US
Mailing Address - Phone:704-375-0100
Mailing Address - Fax:704-887-6450
Practice Address - Street 1:1420 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2408
Practice Address - Country:US
Practice Address - Phone:704-375-0100
Practice Address - Fax:704-887-6450
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054526L207P00000X
NC34251207P00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA011496469Medicaid
NC144AEOtherBCBSNC
NC59-06771Medicaid
NCP00364545OtherRR MEDICARE
SC157145Medicaid
SC157145Medicaid
NC144AEOtherBCBSNC
NC2061887Medicare PIN