Healthcare Provider Details

I. General information

NPI: 1033198700
Provider Name (Legal Business Name): SCOTT ROBERT BERLINER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E BROAD ST
COLUMBUS OH
43213-1502
US

IV. Provider business mailing address

12941 STONECREEK DR UNIT A
PICKERINGTON OH
43147-8424
US

V. Phone/Fax

Practice location:
  • Phone: 614-552-0061
  • Fax: 614-552-0168
Mailing address:
  • Phone: 614-552-0061
  • Fax: 614-552-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35-062768
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: