Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD029740E | PA |
NPI | 1598937245 |
---|---|
Provider Name | Dr. James Craig Berman |
First Address | Merion Station, PA 19066-1133 |
Second Address | Merion Station, PA 19066-1133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 01/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C31437 | (02) | PA |