Provider Demographics
NPI:1053473611
Name:BERKA, NOUREDDINE (PHD, D(ABHI))
Entity Type:Individual
Prefix:DR
First Name:NOUREDDINE
Middle Name:
Last Name:BERKA
Suffix:
Gender:M
Credentials:PHD, D(ABHI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SIMCOE CIRCLE SW
Mailing Address - Street 2:
Mailing Address - City:CALGARY
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T3H4S6
Mailing Address - Country:CA
Mailing Address - Phone:403-680-5355
Mailing Address - Fax:403-685-5526
Practice Address - Street 1:2041 GEORGIA AVE NW
Practice Address - Street 2:SUITE 4B39
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-4337
Practice Address - Fax:202-865-4338
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory