Provider Demographics
NPI:1982346672
Name:BERNING, CHANTAL MARI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANTAL
Middle Name:MARI
Last Name:BERNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHANTAL
Other - Middle Name:MARI
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2261 PHILADELPHIA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1814
Mailing Address - Country:US
Mailing Address - Phone:937-734-4141
Mailing Address - Fax:
Practice Address - Street 1:2261 PHILADELPHIA DR STE 300
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1814
Practice Address - Country:US
Practice Address - Phone:937-734-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.253367390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program