Provider Demographics
NPI:1265402614
Name:BERKMAN, DAVID A (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BERKMAN
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 1:10 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3158
Mailing Address - Country:US
Mailing Address - Phone:413-586-8910
Mailing Address - Fax:413-584-7270
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3158
Practice Address - Country:US
Practice Address - Phone:413-586-8910
Practice Address - Fax:413-584-7270
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81203207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA812031OtherCONNECTICARE
MAJ16092OtherBCBS MA
MA000000006749OtherBMC
MA3138453Medicaid
MA20-1203197OtherCONSOLIDATED
MA20-1203197OtherPLAN VISTA
MA20-1203197OtherUNICARE/GIC
MA24683OtherHEALTH NEW ENGLAND
MA20-1203197OtherGREAT-WEST
MA20-1203197OtherNORTHEAST HEALTHCARE ALLI
MA20-1203197OtherUNITED HEALTHCARE
MA2359394OtherAETNA
MA303278OtherHARVARD PILGRIM
MA20-1203197OtherNORTHEAST HEALTH DIRECT
MA754264OtherTUFTS
MA102540OtherCIGNA
MA20-1203197OtherNORTH AMERICAN PREFERRED
MA20-1203197OtherPRIVATE HEALTHCARE SYSTEM
MA20-1203197OtherNORTHEAST HEALTHCARE ALLI
MA3138453Medicaid