Provider Demographics
NPI:1285040436
Name:BERK NEUROSURGICAL, LLC
Entity Type:Organization
Organization Name:BERK NEUROSURGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHMET
Authorized Official - Middle Name:
Authorized Official - Last Name:BERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-482-5671
Mailing Address - Street 1:6485 SW BORLAND RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062
Mailing Address - Country:US
Mailing Address - Phone:503-482-5671
Mailing Address - Fax:503-482-5764
Practice Address - Street 1:6485 SW BORLAND RD
Practice Address - Street 2:SUITE G
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062
Practice Address - Country:US
Practice Address - Phone:503-482-5671
Practice Address - Fax:503-482-5764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty