Provider Demographics
NPI:1740207190
Name:BERMAN, GINA MECAGNI (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:MECAGNI
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:MECAGNI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10900 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 609
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5216
Mailing Address - Country:US
Mailing Address - Phone:844-504-4500
Mailing Address - Fax:
Practice Address - Street 1:10900 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 609
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5216
Practice Address - Country:US
Practice Address - Phone:844-504-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31260207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ852550-02Medicaid
AZ852550-02Medicaid
I03341Medicare UPIN