MEDICARE: DR. ERIC M BERKSON MD

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	207X00000X	Orthopaedic Surgery Physician	224280	MA
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	224280	MA

General Provider Information

NPI Number	:	1750362737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC M BERKSON MD

Provider Business Mailing Address
First Line	:	20 PATRIOT PL FL 2
Second Line	:
City	:	FOXBORO
State	:	MA
Zip	:	02035-1375
Country	:	US
Telephone Number	:	508-718-4035
Fax Number	:	508-718-4036

Provider Business Practice Location Address
First Line	:	20 PATRIOT PL FL 2
Second Line	:
City	:	FOXBORO
State	:	MA
Zip	:	02035-1375
Country	:	US
Telephone Number	:	508-718-4035
Fax Number	:	508-718-4036

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	11/14/2012

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