Provider Demographics
NPI:1821023219
Name:STERNHILL, VERNON (MD)
Entity Type:Individual
Prefix:MR
First Name:VERNON
Middle Name:
Last Name:STERNHILL
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 1:777 RIVERVIEW DR
Mailing Address - Street 2:STE D208
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022
Mailing Address - Country:US
Mailing Address - Phone:269-927-1248
Mailing Address - Fax:269-927-1701
Practice Address - Street 1:1234 NAPIER AVE
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085
Practice Address - Country:US
Practice Address - Phone:269-983-8300
Practice Address - Fax:269-983-6965
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010241752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4401474Medicaid
MIOA16007015Medicare ID - Type Unspecified
B48111Medicare UPIN