Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD28471 | OR |
NPI | 1275707606 |
---|---|
Provider Name | Dr. Emily Berry |
First Address | Bend, OR 97701-6752 |
Second Address | Bend, OR 97701-6015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 09/10/2020 |