Provider Demographics
NPI:1508869835
Name:BERMAN, LARRY F (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:F
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10620 PARK RD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8472
Mailing Address - Country:US
Mailing Address - Phone:704-542-6111
Mailing Address - Fax:704-542-1239
Practice Address - Street 1:10620 PARK RD
Practice Address - Street 2:STE 128
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8472
Practice Address - Country:US
Practice Address - Phone:704-542-6111
Practice Address - Fax:704-542-1239
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2012-02-01
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Provider Licenses
StateLicense IDTaxonomies
NC39238207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE52625Medicare UPIN