Provider Demographics
NPI:1750334058
Name:BERARDI, JOSEPH CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHRISTOPHER
Last Name:BERARDI
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 1:8900 E. BAHIA DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-502-4567
Mailing Address - Fax:480-502-0353
Practice Address - Street 1:8900 E. BAHIA DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-502-4567
Practice Address - Fax:480-502-0353
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35007208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ158947Medicare UPIN
AZ110765Medicare PIN