Provider Demographics
NPI:1942371877
Name:BERMAN, EVE TAMAR (DO)
Entity Type:Individual
Prefix:DR
First Name:EVE
Middle Name:TAMAR
Last Name:BERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 880652
Mailing Address - Street 2:
Mailing Address - City:PUKALANI
Mailing Address - State:HI
Mailing Address - Zip Code:96788-0652
Mailing Address - Country:US
Mailing Address - Phone:808-573-1677
Mailing Address - Fax:808-573-6377
Practice Address - Street 1:3660 BALDWIN AVE
Practice Address - Street 2:#2C
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-7503
Practice Address - Country:US
Practice Address - Phone:808-573-1677
Practice Address - Fax:808-573-6377
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS954208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
100899Medicare ID - Type Unspecified
100898Medicare ID - Type Unspecified
E99953Medicare UPIN