Individual
SUSAN ELAINE BERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1110 OAKWOOD AVE, OAKWOOD, OH 45419-2911
(937) 885-7163
(937) 567-0670
Mailing address
1110 OAKWOOD AVE, OAKWOOD, OH 45419-2911
(937) 885-7163
(937) 567-0670
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
35082769
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2428859
—
OH
Enumeration date
11/28/2005
Last updated
07/17/2019
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