Provider Demographics
NPI:1225015829
Name:BERMAN, ARI S (MD)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:S
Last Name:BERMAN
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 1:175 FORE RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2779
Mailing Address - Country:US
Mailing Address - Phone:207-857-8040
Mailing Address - Fax:207-275-4828
Practice Address - Street 1:175 FORE RIVER PKWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2779
Practice Address - Country:US
Practice Address - Phone:207-879-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217337208M00000X
MEMD19747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1225015829Medicaid
MAP00272730OtherRR MEDICARE
MA110033944/AMedicaid
ME003433001OtherMEDICARE PTAN
MEP01241296OtherRAILROAD MEDICARE
ME1225015829Medicaid