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General NPI Number Information
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NPI Number | 1679623326
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Entity Type | Individual
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Provider Name | JONATHAN H BERKOFF MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 2350 N LAKE DR SUITE 500
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City | MILWAUKEE
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State | WI
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Zip | 53211-4528
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Country | US
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Telephone | 414-289-9669
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Fax | 414-289-9693
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Provider Business Mailing Address
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Address Line | 2350 N LAKE DR SUITE 500
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City | MILWAUKEE
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State | WI
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Zip | 53211-4528
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Country | US
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Telephone | 414-289-9669
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Fax | 414-289-9693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 37497
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License Number State | WI
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