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General NPI Number Information
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NPI Number | 1700727351
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Entity Type | Individual
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Provider Name | BERKLEY KEITH STEWART
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Gender | Male
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 100 PROFESSIONAL PL STE 107
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City | CARROLLTON
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State | GA
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Zip | 30117-3827
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Country | US
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Telephone | 770-291-8987
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 THE EXCHANGE SE STE 600
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City | ATLANTA
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State | GA
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Zip | 30339-2050
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Country | US
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Telephone | 770-291-8987
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP288832
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License Number State | GA
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