Provider Demographics
NPI:1336118983
Name:BERMAN, KEVIN S (MD, , PHD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:S
Last Name:BERMAN
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Gender:M
Credentials:MD, , PHD
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Mailing Address - Street 1:1265 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1257
Mailing Address - Country:US
Mailing Address - Phone:770-751-1433
Mailing Address - Fax:770-751-7410
Practice Address - Street 1:1265 UPPER HEMBREE RD
Practice Address - Street 2:STE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1143
Practice Address - Country:US
Practice Address - Phone:770-751-1133
Practice Address - Fax:770-751-7410
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-11-02
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Provider Licenses
StateLicense IDTaxonomies
GA057044207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA07BBSSMMedicare PIN
GAI52276Medicare UPIN