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General NPI Number Information
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NPI Number | 1114343183
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Entity Type | Organization
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Legal Business Name | B PEDIATRICS, LLC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 410 MALL BLVD SUITE 410B
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City | SAVANNAH
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State | GA
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Zip | 31406-4821
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Country | US
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Telephone | 912-472-0314
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Fax | 912-472-0315
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Provider Business Mailing Address
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Address Line | 110 E 49TH ST
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City | SAVANNAH
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State | GA
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Zip | 31405-2134
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Country | US
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Telephone | 912-472-0314
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Fax | 912-472-0315
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. KASEY R BERMAN
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Credential | MD
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Telephone | 912-507-8386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 55095
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License Number State | GA
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