Provider Demographics
NPI:1114343183
Name:B PEDIATRICS, LLC
Entity Type:Organization
Organization Name:B PEDIATRICS, LLC
Other - Org Name:BE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-507-8386
Mailing Address - Street 1:110 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-2134
Mailing Address - Country:US
Mailing Address - Phone:912-472-0314
Mailing Address - Fax:912-472-0315
Practice Address - Street 1:410 MALL BLVD
Practice Address - Street 2:SUITE 410B
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4821
Practice Address - Country:US
Practice Address - Phone:912-472-0314
Practice Address - Fax:912-472-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55095208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty