MEDICARE: DR. ELIZA BERKLEY 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	207VX0000X	Obstetrics Physician	20050184	NM
2	207VM0101X	Maternal & Fetal Medicine Physician	0101241848	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10265084	OTHER		OPTIMA/SENTARA
2	303352	OTHER	VA	ANTHEM FF
3	PAR	OTHER	VA	VIRGINIA PREMIER HEALTH
4	PAR	OTHER	VA	CIGNA
5	303361	OTHER	VA	ANTHEM FC
6	1871569517	OTHER		UNITED HEALTHCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
9	PAR	OTHER	VA	MULTIPLAN
10	07694	OTHER	NC	NC BC/BS
11	1871569517	OTHER		TRICARE EAST
12	303374	OTHER	VA	ANTHEM JCM
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	PAR	OTHER	VA	CORVEL/CORCARE
15	303377	OTHER	VA	ANTHEM COLLEY
16	PAR	OTHER	VA	USA MANAGED CARE
17	PAR	OTHER	VA	FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
18	PAR	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1871569517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZA BERKLEY MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23501-0936
Country	:	US
Telephone Number	:	757-573-6033
Fax Number	:	757-624-2254

Provider Business Practice Location Address
First Line	:	6433 ELEANOR CT
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-1009
Country	:	US
Telephone Number	:	704-685-2945
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	11/15/2021

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