Provider Demographics
NPI:1205845492
Name:TOPOUZIAN, KERI BERGE (DO)
Entity Type:Individual
Prefix:DR
First Name:KERI
Middle Name:BERGE
Last Name:TOPOUZIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0238
Mailing Address - Country:US
Mailing Address - Phone:248-302-0473
Mailing Address - Fax:248-927-0888
Practice Address - Street 1:1900 S TELEGRAPH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0238
Practice Address - Country:US
Practice Address - Phone:248-302-0473
Practice Address - Fax:248-927-0888
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008226207P00000X, 208D00000X, 207Q00000X
TXQ2627207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP53760002Medicare PIN