Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2019-02092 | NC |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4302 | TN |
NPI | 1083092449 |
---|---|
Provider Name | Dr. Alexander Paul Berwick |
First Address | Chattanooga, TN 37403-1405 |
Second Address | Chattanooga, TN 37403-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2015 |
Last Update Date | 27/08/2021 |