Provider Demographics
NPI:1558072322
Name:BERNING, WILLIAM PATRICK
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PATRICK
Last Name:BERNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-1041
Mailing Address - Country:US
Mailing Address - Phone:763-367-0561
Mailing Address - Fax:
Practice Address - Street 1:420 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5147
Practice Address - Country:US
Practice Address - Phone:317-274-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant