MEDICARE: ANDREW N BERMAN DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	16381	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306848320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW N BERMAN DDS

Provider Business Mailing Address
First Line	:	911 E AURORA RD
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44056-1905
Country	:	US
Telephone Number	:	330-467-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 E AURORA RD
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44056-1905
Country	:	US
Telephone Number	:	330-467-1800
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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