Provider Demographics
NPI:1417950973
Name:BERESH, ARNOLD SHERMAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:SHERMAN
Last Name:BERESH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:417 CHADWICK PL
Mailing Address - Street 2:STE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3169
Mailing Address - Country:US
Mailing Address - Phone:757-503-0479
Mailing Address - Fax:757-223-7653
Practice Address - Street 1:2202 EXECUTIVE DR
Practice Address - Street 2:STE A
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6604
Practice Address - Country:US
Practice Address - Phone:757-827-7111
Practice Address - Fax:757-827-7164
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000640213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9303642Medicaid
VA9303642Medicaid
VA9303642Medicaid
VAT21774Medicare UPIN
VA480000620Medicare ID - Type Unspecified