Provider Demographics
NPI:1942273461
Name:BERRYHILL, EVE CHARITY (MD)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:CHARITY
Last Name:BERRYHILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 TECHNOLOGY DR NE
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2275
Mailing Address - Country:US
Mailing Address - Phone:320-231-5421
Mailing Address - Fax:
Practice Address - Street 1:1701 TECHNOLOGY DR NE
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-2275
Practice Address - Country:US
Practice Address - Phone:320-231-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN446462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN761144700Medicaid
MN260002100Medicare ID - Type Unspecified
H66777Medicare UPIN
MN260050434Medicare ID - Type UnspecifiedRAILROAD