Provider Demographics
NPI:1033188636
Name:BERKENWALD, ALAN D (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:BERKENWALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 HALL DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:413-256-8561
Mailing Address - Fax:866-644-0869
Practice Address - Street 1:31 HALL DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-256-8561
Practice Address - Fax:866-644-0869
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2425133OtherAETNA
MA04-3194547OtherPLAN VISTA
MA044660OtherCONNECTICARE
MAG01054OtherBCBSMA
MA04-3194547OtherCONSOLIDATED
MA27157OtherHEALTH NEW ENGLAND
MA04-3194547OtherUNICARE/GIC
MA69914OtherHARVARD PILGRIM
MA000000007564OtherBMC
MD04-3194547OtherPRIVATE HEALTHCARE SYSTEM
MA10216603OtherCIGNA
MA1033188636Medicaid
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherPRIVATE HEALTHCARE SYSTEM
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA04-3194547OtherGREAT-WEST
MA044660OtherTUFTS
MA1033188636Medicaid
MA044660OtherCONNECTICARE
MA69914OtherHARVARD PILGRIM