MEDICARE: MICHAEL EDWARD BERKELEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	F3042	TX
2	207X00000X	Orthopaedic Surgery Physician	DRP 0000604	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013971134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL EDWARD BERKELEY M.D.

Provider Business Mailing Address
First Line	:	1302 WAUGH DR # 684
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-3908
Country	:	US
Telephone Number	:	970-230-0154
Fax Number	:	970-315-0374

Provider Business Practice Location Address
First Line	:	1302 WAUGH DR # 684
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-3908
Country	:	US
Telephone Number	:	970-230-0154
Fax Number	:	970-315-0374

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	04/26/2017

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