Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 12151 | AL |
NPI | 1013915099 |
---|---|
Provider Name | Dr. Michael Alan Berry |
First Address | Foley, AL 36535-2208 |
Second Address | Foley, AL 36535-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 13/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000034907 | (05) | AL |
0510-34907 | BCBS (01) | AL |
0515-13766 | BCBS (01) | AL |
100015318 | RAILROAD MEDCARE (01) | AL |
2910028 | UNITED HEALTHCARE (01) | AL |
5581199 | AETNA (01) | AL |
C73041 | (02) | AL |