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General NPI Number Information
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NPI Number | 1992101174
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Entity Type | Organization
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Legal Business Name | MELVYN ROY BERMAN, O.D., P.A
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Dates
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Enumeration Date | 11/14/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 1601 E MILLBROOK RD
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City | RALEIGH
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State | NC
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Zip | 27609-4908
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Country | US
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Telephone | 919-872-2020
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Fax | 919-872-3207
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Provider Business Mailing Address
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Address Line | 1601 E MILLBROOK RD
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City | RALEIGH
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State | NC
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Zip | 27609-4908
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Country | US
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Telephone | 919-872-2020
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Fax | 919-872-3207
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Authorized Official
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Title or Position | O.D./OWNER
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Name | DR. MELVYN ROY BERMAN
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Credential | O.D.
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Telephone | 919-872-2020
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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 | NC0862
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License Number State | NC
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