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NPI Code Detail

MEDICARE: MERRILL BERMAN M.D.

MEDICARE:   MERRILL  BERMAN  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
12085R0202XDiagnostic Radiology Physician010102GA

General Provider Information

NPI Number : 1720072226
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRILL BERMAN M.D.
Provider Business Mailing Address
First Line : 3001 S COBB DR SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-7809
Country : US
Telephone Number : 404-432-2577
Fax Number :
Provider Business Practice Location Address
First Line : 1046 RIDGE AVE SW
Second Line :
City : ATLANTA
State : GA
Zip : 30315-1640
Country : US
Telephone Number : 404-688-1350
Fax Number : 404-688-2962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 07/08/2007

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Directions to “ MERRILL BERMAN M.D.” Practice Location

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