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NPI Code Detail

MEDICARE: KASEY REEVES BERMAN M.D.

MEDICARE: KASEY REEVES 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
1208000000XPediatrics Physician055095GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932144532
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY REEVES BERMAN M.D.
Provider Business Mailing Address
First Line : 410 MALL BLVD STE B
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-4869
Country : US
Telephone Number : 912-472-0314
Fax Number : 912-472-0315
Provider Business Practice Location Address
First Line : 410 MALL BLVD STE B
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-4869
Country : US
Telephone Number : 912-472-0314
Fax Number : 912-472-0315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 06/02/2014

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