MEDICARE: DR GEORGE E BERRYMAN 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	122300000X	Dentist	0401005731	VA

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	:	1528040474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR GEORGE E BERRYMAN DDS

Provider Business Mailing Address
First Line	:	838 OLD GEORGE WASHINGTON HWY
Second Line	:	SUITE C
City	:	CHESAPEAKE
State	:	VA
Zip	:	23323
Country	:	US
Telephone Number	:	757-558-9008
Fax Number	:	757-558-9042

Provider Business Practice Location Address
First Line	:	838 OLD GEORGE WASHINGTON HWY
Second Line	:	SUITE C
City	:	CHESAPEAKE
State	:	VA
Zip	:	23323
Country	:	US
Telephone Number	:	757-558-9008
Fax Number	:	757-558-9042

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JOANN P REYNOLDS
Credential	:
Telephone Number	:	757-558-9008

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	06/23/2008

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