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NPI 1811135908

NPI 1811135908 : JEFF MATTHEW BERRY M.D. : SPARTANBURG, SC

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General NPI Number Information
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    NPI Number           |    1811135908
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    Entity Type          |    Individual 
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    Provider Name        |    JEFF MATTHEW BERRY M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/27/2009
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    Last Update Date     |    10/21/2025
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Provider Practice Location Address
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    Address Line         |    1083 BOILING SPRINGS RD 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29303-2248
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    Country              |    US
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    Telephone            |    864-583-8647
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    Fax                  |    864-542-2227
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Provider Business Mailing Address
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    Address Line         |    PO BOX 743070 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30374-3070
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    Country              |    US
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    Telephone            |    864-560-4304
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    Fax                  |    864-560-4413
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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        |    207RC0001X
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    Taxonomy Name        |    Clinical Cardiac Electrophysiology Physician
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    License Number       |    35054
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    License Number State |    SC
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Taxonomy #2
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    35054
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    License Number State |    SC
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Taxonomy #3
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    M3911
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    License Number State |    TX
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