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NPI Code Detail

MEDICARE: DR. CHRISTINA L BEREDA D.O.

MEDICARE: DR. CHRISTINA L BEREDA D.O.
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
1207Q00000XFamily Medicine Physician036141112IL

General Provider Information

NPI Number : 1437386083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA L BEREDA D.O.
Provider Business Mailing Address
First Line : 4 MEMORIAL DR STE 210
Second Line :
City : ALTON
State : IL
Zip : 62002-6704
Country : US
Telephone Number : 618-463-5905
Fax Number :
Provider Business Practice Location Address
First Line : 3 SAINT ELIZABETH BLVD STE 4000
Second Line :
City : O FALLON
State : IL
Zip : 62269-1284
Country : US
Telephone Number : 618-233-5480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2009
Last Update Date : 12/14/2022

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Directions to “ DR. CHRISTINA L BEREDA D.O.” Practice Location

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