Provider Demographics
NPI:1902816002
Name:BERKEBILE, DAVID G (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:BERKEBILE
Suffix:
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 1:801 SCALP AVE.
Mailing Address - Street 2:SUITE 113
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904
Mailing Address - Country:US
Mailing Address - Phone:814-266-3775
Mailing Address - Fax:
Practice Address - Street 1:801 SCALP AVE.
Practice Address - Street 2:SUITE 113
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904
Practice Address - Country:US
Practice Address - Phone:814-266-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007550-L111N00000X
PAAJ-007550-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00124068OtherPALMETTO GBA
PABE915317OtherBLUE CROSS BLUE SHIELD
PA218636OtherUPMC
PABE915317OtherBLUE CROSS BLUE SHIELD