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General NPI Number Information
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NPI Number | 1841618980
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Entity Type | Organization
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Legal Business Name | BERKELEY MEDICINE & CONSULTING
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Dates
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Enumeration Date | 04/05/2014
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Last Update Date | 04/05/2014
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Provider Practice Location Address
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Address Line | 201 17TH ST NW SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30363-1098
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Country | US
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Telephone | 678-538-6422
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Fax | 678-538-6423
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Provider Business Mailing Address
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Address Line | 201 17TH ST NW SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30363-1098
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Country | US
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Telephone | 678-538-6422
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Fax | 678-538-6423
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Authorized Official
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Title or Position | OWNER / PSYCHIATRIST
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Name | DR. MALAIKA E. BERKELEY
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Credential | MD
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Telephone | 678-538-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 057582
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License Number State | GA
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