Healthcare Provider Details

I. General information

NPI: 1225847338
Provider Name (Legal Business Name): CHRISTOPHER N BERRYMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRIANGLE PARK DR
CINCINNATI OH
45246-3423
US

IV. Provider business mailing address

1 TRIANGLE PARK DR
CINCINNATI OH
45246-3423
US

V. Phone/Fax

Practice location:
  • Phone: 614-657-3246
  • Fax:
Mailing address:
  • Phone: 513-963-6224
  • Fax: 866-542-4862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number005311
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: