Healthcare Provider Details

I. General information

NPI: 1053473611
Provider Name (Legal Business Name): NOUREDDINE BERKA PH.D., D(ABHI)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW SUITE 4B39
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

33 SIMCOE CIRCLE SW
CALGARY ALBERTA
T3H4S6
CA

V. Phone/Fax

Practice location:
  • Phone: 202-865-4337
  • Fax: 202-865-4338
Mailing address:
  • Phone: 403-680-5355
  • Fax: 403-685-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: