MEDICARE: DAVID P. BERRY 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	207W00000X	Ophthalmology Physician	7904	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180024839	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0999930001	OTHER		DMERC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841292653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID P. BERRY MD

Provider Business Mailing Address
First Line	:	1330 BOILING SPRINGS RD
Second Line	:	SUITE 2400
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4201
Country	:	US
Telephone Number	:	864-583-5312
Fax Number	:	864-582-1935

Provider Business Practice Location Address
First Line	:	1330 BOILING SPRINGS RD
Second Line	:	SUITE 2400
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4201
Country	:	US
Telephone Number	:	864-583-5312
Fax Number	:	864-582-1935

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/07/2011

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Directions to “ DAVID P. BERRY MD” Practice Location

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