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NPI Code Detail

MEDICARE: DR. ROBIN G BERDING O.D

MEDICARE:  DR. ROBIN G BERDING  O.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
1152W00000XOptometrist001177GA
2152W00000XOptometristOPC2705FL
3152W00000XOptometristOPT001177GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152295473OTHERGABLUE CROSS BLUE SHIELD GA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710047329
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBIN G BERDING O.D
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-2442
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 105 GRAND CENTRAL BLVD STE 110
Second Line :
City : POOLER
State : GA
Zip : 31322-4148
Country : US
Telephone Number : 912-450-9200
Fax Number : 912-450-9201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 12/27/2022

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Directions to “ DR. ROBIN G BERDING O.D” Practice Location

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