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General NPI Number Information
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NPI Number | 1831282938
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Entity Type | Individual
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Provider Name | DIRK L BERRY MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 1649 MCFARLAND BLVD N SUITE 203
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2281
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Country | US
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Telephone | 205-556-5541
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Fax | 205-554-7937
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Provider Business Mailing Address
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Address Line | 1649 MCFARLAND BLVD N SUITE 203
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2281
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Country | US
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Telephone | 205-556-5541
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Fax | 205-554-7937
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 000016499
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License Number State | AL
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