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General NPI Number Information
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NPI Number | 1740398437
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Entity Type | Organization
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Legal Business Name | MICHAEL S. BERK, O.D. INC.
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 951 E JOHNSTOWN RD
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City | GAHANNA
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State | OH
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Zip | 43230-1851
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Country | US
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Telephone | 614-476-2015
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Fax | 614-428-9856
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Provider Business Mailing Address
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Address Line | 951 E JOHNSTOWN RD
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City | GAHANNA
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State | OH
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Zip | 43230-1851
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Country | US
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Telephone | 614-476-2015
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Fax | 614-428-9856
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Authorized Official
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Title or Position | OD OWNER
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Name | MICHAEL S BERK
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Credential | O.D,F.A.A.O.
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Telephone | 614-476-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | OH
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