Healthcare Provider Details

I. General information

NPI: 1942273461
Provider Name (Legal Business Name): EVE CHARITY BERRYHILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 TECHNOLOGY DR NE
WILLMAR MN
56201-2275
US

IV. Provider business mailing address

1701 TECHNOLOGY DR NE
WILLMAR MN
56201-2275
US

V. Phone/Fax

Practice location:
  • Phone: 320-231-5421
  • Fax:
Mailing address:
  • Phone: 320-231-5421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number44646
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: