Provider Demographics
NPI:1932104320
Name:BERLIN, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:BERLIN
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 1:1535 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1611
Mailing Address - Country:US
Mailing Address - Phone:302-645-4700
Mailing Address - Fax:302-645-1038
Practice Address - Street 1:1535 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1611
Practice Address - Country:US
Practice Address - Phone:302-645-4700
Practice Address - Fax:302-645-1038
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004435207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000605201Medicaid
DEE21405Medicare UPIN
DE550945B15Medicare ID - Type UnspecifiedMEDICARE #