MEDICARE: DR. ALAN LEE BERMAN PH.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
1	103TC0700X	Clinical Psychologist	PSY7	DC

General Provider Information

NPI Number	:	1881716710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN LEE BERMAN PH.D.

Provider Business Mailing Address
First Line	:	7200 MAPLE AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-5110
Country	:	US
Telephone Number	:	301-657-9367
Fax Number	:	202-237-2282

Provider Business Practice Location Address
First Line	:	5221 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20015-2032
Country	:	US
Telephone Number	:	202-237-2280
Fax Number	:	202-237-2282

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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