Provider Demographics
NPI:1417030586
Name:BERMAN, EARL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:JOSEPH
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 1:1570 BEECHCLIFF DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3826
Mailing Address - Country:US
Mailing Address - Phone:404-982-5479
Mailing Address - Fax:
Practice Address - Street 1:1570 BEECHCLIFF DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3826
Practice Address - Country:US
Practice Address - Phone:404-982-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA32347207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine