Provider Demographics
NPI:1457303539
Name:BERMAN MEDICAL CONSULTING, PC
Entity Type:Organization
Organization Name:BERMAN MEDICAL CONSULTING, PC
Other - Org Name:VALLEY WOUND CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-347-0844
Mailing Address - Street 1:6320 W UNION HILLS DRIVE
Mailing Address - Street 2:BUILDING A, SUITE 140
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308
Mailing Address - Country:US
Mailing Address - Phone:480-347-0844
Mailing Address - Fax:480-347-0885
Practice Address - Street 1:6320 W UNION HILLS DRIVE
Practice Address - Street 2:BUILDING A, SUITE 140
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:480-347-0844
Practice Address - Fax:480-347-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0784280OtherBCBS
AZ464173Medicaid
AZ104163Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
AZ464173Medicaid
AZZ104162Medicare PIN