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General NPI Number Information
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NPI Number | 1972559367
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Entity Type | Individual
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Provider Name | MARK A BERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 15 OLD ROLLINSFORD RD SUITE 102
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City | DOVER
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State | NH
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Zip | 03820-2868
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Country | US
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Telephone | 603-742-7338
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Fax | 603-740-9528
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Provider Business Mailing Address
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Address Line | 789 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-2526
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Country | US
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Telephone | 603-742-7338
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Fax | 603-740-9528
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9669
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD18166
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License Number State | ME
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