Provider Demographics
NPI:1023120052
Name:BERMAN, NEIL ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ADAM
Last Name:BERMAN
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 1:2495 E WEST CONNECTOR STE 90
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-6816
Mailing Address - Country:US
Mailing Address - Phone:678-567-0566
Mailing Address - Fax:678-567-5277
Practice Address - Street 1:2495 E WEST CONNECTOR STE 90
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-6816
Practice Address - Country:US
Practice Address - Phone:678-567-0566
Practice Address - Fax:678-567-5277
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHFZMedicare ID - Type Unspecified