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1043217458

NPI Code Detail

MEDICARE: DR. JERRY E BERLAND M.D.

MEDICARE: DR. JERRY E BERLAND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	045397	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	180033858	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3146	OTHER	GA	COVENTRY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	328787	OTHER	GA	WELLCARE
5	13137	OTHER	GA	COVENTRY PPO
6	582209517	OTHER	GA	WORK COMP
7	0816345	OTHER	GA	UHC
8	10040682	OTHER	GA	AMERIGROUP
9	863814	OTHER	GA	BCBS
10	5528131	OTHER	GA	AETNA
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	2060975	OTHER	GA	AETNA HMO
13	701836	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1043217458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY E BERLAND M.D.

Provider Business Mailing Address
First Line	:	5901A PEACHTREE DUNWOODY RD NE
Second Line	:	STE 500
City	:	ATLANTA
State	:	GA
Zip	:	30328-5382
Country	:	US
Telephone Number	:	404-256-1507
Fax Number	:	404-250-0440

Provider Business Practice Location Address
First Line	:	5995 BARFIELD RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4411
Country	:	US
Telephone Number	:	404-256-1507
Fax Number	:	404-250-0440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/08/2021

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Directions to “ DR. JERRY E BERLAND M.D.” Practice Location

Language	Start Address	Practice Location

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