Provider Demographics
NPI:1326163999
Name:BERNIE, STEPHEN ROSS (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ROSS
Last Name:BERNIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24300 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5639
Mailing Address - Country:US
Mailing Address - Phone:216-454-0009
Mailing Address - Fax:216-991-5190
Practice Address - Street 1:24300 CHAGRIN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5639
Practice Address - Country:US
Practice Address - Phone:216-454-0009
Practice Address - Fax:216-991-5190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OH029203207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA 75481Medicare UPIN