Healthcare Provider Details

I. General information

NPI: 1811004435
Provider Name (Legal Business Name): SCOTT STEVEN BERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W ST MARYS RD
TUSCON AZ
85745-2653
US

IV. Provider business mailing address

3709 N CAMPBELL AVE STE 201
TUCSON AZ
85719-1563
US

V. Phone/Fax

Practice location:
  • Phone: 520-628-1400
  • Fax: 520-628-4863
Mailing address:
  • Phone: 520-838-3540
  • Fax: 520-325-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number20643
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: