MEDICARE: DR. ANDREW MARK BERKOWITZ 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
1	207R00000X	Internal Medicine Physician	MD036462E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0081708000	OTHER	PA	KEYSTONE HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0081708000	OTHER	PA	BLUE SHIELD AND HIGHMARK

General Provider Information

NPI Number	:	1952454928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW MARK BERKOWITZ M.D.

Provider Business Mailing Address
First Line	:	725 LISA CIR
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-2223
Country	:	US
Telephone Number	:	215-947-6143
Fax Number	:	215-947-6274

Provider Business Practice Location Address
First Line	:	1718 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4213
Country	:	US
Telephone Number	:	215-947-6143
Fax Number	:	215-947-6274

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

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	08/08/2014

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