Healthcare Provider Details

I. General information

NPI: 1740074640
Provider Name (Legal Business Name): MARK BERKOWITZ MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44650 DELCO BLVD STE 100
STERLING HEIGHTS MI
48313-1063
US

IV. Provider business mailing address

44650 DELCO BLVD STE 100
STERLING HEIGHTS MI
48313-1063
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-7692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE NEMER
Title or Position: CEO
Credential:
Phone: 586-254-1770