Provider Demographics
NPI:1821076423
Name:BERKOWITZ, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:BERKOWITZ
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 1:21785 FILIGREE COURT
Mailing Address - Street 2:#101
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6214
Mailing Address - Country:US
Mailing Address - Phone:703-726-1201
Mailing Address - Fax:703-858-7150
Practice Address - Street 1:4001 FAIR RIDGE DR
Practice Address - Street 2:#103, FAIR OAKS IMAGING CENTER
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2917
Practice Address - Country:US
Practice Address - Phone:703-385-5203
Practice Address - Fax:703-385-3058
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010436662085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7232250Medicaid
E41500Medicare UPIN
VA7232250Medicaid