Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 045397 | GA |
NPI | 1043217458 |
---|---|
Provider Name | Dr. Jerry E Berland |
First Address | Atlanta, GA 30328-5382 |
Second Address | Sandy Springs, GA 30328-4411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00791909E | (05) | GA |
00791909F | (05) | GA |
0816345 | UHC (01) | GA |
10040682 | AMERIGROUP (01) | GA |
13137 | COVENTRY PPO (01) | GA |
180033858 | RR MEDICARE (01) | GA |
2060975 | AETNA HMO (01) | GA |
3146 | COVENTRY (01) | GA |
328787 | WELLCARE (01) | GA |
5528131 | AETNA (01) | GA |
582209517 | WORK COMP (01) | GA |
701836 | BCBS (01) | GA |
863814 | BCBS (01) | GA |
F87730 | (02) | GA |