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General NPI Number Information
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NPI Number | 1194040758
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Entity Type | Organization
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Legal Business Name | FRANK W BERRY JR MD INC
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 3178 COLLINS DR SUITE B
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City | MERCED
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State | CA
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Zip | 95348-3155
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Country | US
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Telephone | 209-383-6484
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Fax | 209-383-5315
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Provider Business Mailing Address
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Address Line | 3178 COLLINS DR SUITE B
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City | MERCED
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State | CA
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Zip | 95348-3155
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Country | US
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Telephone | 209-383-6484
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Fax | 209-383-5315
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK WELDON BERRY JR.
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Credential | M.D.
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Telephone | 209-383-6484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | C39601
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License Number State | CA
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