Provider Demographics
NPI:1477544435
Name:KERNERMAN, STEVEN M (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:KERNERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 N WASHINGTON ST STE 4200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2476
Mailing Address - Country:US
Mailing Address - Phone:509-747-1624
Mailing Address - Fax:
Practice Address - Street 1:1330 N WASHINGTON ST STE 4200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2476
Practice Address - Country:US
Practice Address - Phone:509-747-1624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001363207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5792115OtherAETNA
IDK6039OtherHMO BLUE CROSS OF IDAHO
WA0099164OtherL&I
WA030004123OtherRAILROAD MEDICARE
WA8188690Medicaid
ID003277400OtherIDAHO MEDICAID
WAG11003Medicare UPIN
IDK6039OtherHMO BLUE CROSS OF IDAHO