1528164415 NPI number — DR. STEVEN W WERNS M.D.

Table of content: DR. STEVEN W WERNS M.D. (NPI 1528164415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528164415 NPI number — DR. STEVEN W WERNS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WERNS
Provider First Name:
STEVEN
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528164415
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26901 BEAUMONT BLVD
Provider Second Line Business Mailing Address:
STE 3D
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48033-3849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22060 BEECH ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEARBORN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48124-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-228-0505
Provider Business Practice Location Address Fax Number:
313-228-0506
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  4301045455 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1724549 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2961060 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K1458 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2635277 . This is a "OXFORD HEALTH PLA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010003749 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9971740 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1158396 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060068592 . This is a "RAIL ROAD MEDICAARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2090442000 . This is a "AMERIHEALTH, HMO, KEYSTONE, IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1401881 . This is a "AMERIHEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 38943 . This is a "UNIVERSITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8862401 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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