Provider Demographics
NPI:1508949264
Name:BERKI, GEORGE DAVID II (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DAVID
Last Name:BERKI
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 MUIRWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4735
Mailing Address - Country:US
Mailing Address - Phone:440-934-8416
Mailing Address - Fax:
Practice Address - Street 1:36490 DETROIT RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1590
Practice Address - Country:US
Practice Address - Phone:440-934-2333
Practice Address - Fax:440-934-2344
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0989239Medicaid
OH0989239Medicaid
OHBE0777581Medicare ID - Type Unspecified