Healthcare Provider Details

I. General information

NPI: 1114363819
Provider Name (Legal Business Name): CHARLES ANIM BERKO M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: N/A N/A N/A MD, MPH

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR
GWYNN OAK MD
21207-6665
US

IV. Provider business mailing address

PO BOX 5827
PIKESVILLE MD
21282-5827
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-2500
  • Fax:
Mailing address:
  • Phone: 443-417-3075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0082420
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0082420
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: