Individual
STACEY HALE BERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 CROSSROADS DR, SUITE 210, OWINGS MILLS, MD 21117-5458
(410) 484-8088
(410) 581-9485
Mailing address
10 CROSSROADS DR, SUITE 210, OWINGS MILLS, MD 21117-5458
(410) 484-8088
(410) 581-9485
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101045738
VA
207X00000X
Orthopaedic Surgery Physician
Primary
D0046117
MD
207XS0106X
Orthopaedic Hand Surgery Physician
C10005022
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160631000
—
MD
01
—
53253404
BLUE SHIELD
MD
01
—
W5200002
BLUE SHIELD
DC
Enumeration date
08/03/2006
Last updated
08/03/2010
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