Provider Demographics
NPI:1114001310
Name:BERKOWITZ, DAVID VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VICTOR
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6224 SWANBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-5203
Mailing Address - Country:US
Mailing Address - Phone:513-467-1722
Mailing Address - Fax:
Practice Address - Street 1:6224 SWANBROOK LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-5203
Practice Address - Country:US
Practice Address - Phone:513-467-1722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0326382084P0800X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0697750Medicaid
OH0697750Medicaid
OH0414991Medicare PIN