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General NPI Number Information
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NPI Number | 1215982269
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Entity Type | Organization
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Legal Business Name | SOSALE BERKUCHEL MD
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 44 S MORSE ST
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City | SANDUSKY
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State | MI
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Zip | 48471-1331
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Country | US
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Telephone | 810-648-4405
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Fax |
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Provider Business Mailing Address
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Address Line | 3061 CHRISTY WAY C.O PRO MED BILLING
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City | SAGINAW
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State | MI
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Zip | 48603-2267
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Country | US
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Telephone | 989-791-2433
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SOSALE BERKUCHEL
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Credential | MD
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Telephone | 810-648-4733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301042585
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License Number State | MI
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