Healthcare Provider Details

I. General information

NPI: 1831117548
Provider Name (Legal Business Name): ALAN M. BERKOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S. HUDSON SUITE 6
SILVER CITY NM
88061
US

IV. Provider business mailing address

P.O. BOX 1349
SILVER CITY NM
88062-1349
US

V. Phone/Fax

Practice location:
  • Phone: 575-388-4412
  • Fax: 505-534-1150
Mailing address:
  • Phone: 505-388-4497
  • Fax: 505-534-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9212
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number92-12
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: