Provider Demographics
NPI:1790171593
Name:BERINSTEIN, ELLERY (MD)
Entity Type:Individual
Prefix:
First Name:ELLERY
Middle Name:
Last Name:BERINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELLERY
Other - Middle Name:
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR STE J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:49650 CHERRY HILL RD STE 220
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4860
Practice Address - Country:US
Practice Address - Phone:734-398-7888
Practice Address - Fax:734-398-7885
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301500244207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program