Provider Demographics
NPI:1518924737
Name:BERNS, DAVID HERSCHEL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HERSCHEL
Last Name:BERNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37115 MILES RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2338
Mailing Address - Country:US
Mailing Address - Phone:216-299-4100
Mailing Address - Fax:
Practice Address - Street 1:37115 MILES RD
Practice Address - Street 2:
Practice Address - City:MORELAND HILLS
Practice Address - State:OH
Practice Address - Zip Code:44022-2338
Practice Address - Country:US
Practice Address - Phone:216-514-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4186722085R0202X
FLME883212085R0202X
IL0361090152085R0202X
NY2344352085R0202X
IN01059855A2085R0202X
MI43010828252085R0202X
WI46402-0202085R0202X
WV217962085R0202X
OH0512102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0744912Medicaid
OH0744912Medicaid
OH4134832Medicare PIN
A17298Medicare UPIN