Provider Demographics
NPI:1831194190
Name:BERZINS, ULDIS JANIS (MD)
Entity type:Individual
Prefix:DR
First Name:ULDIS
Middle Name:JANIS
Last Name:BERZINS
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 1:655 MEDICAL CENTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-581-5287
Mailing Address - Fax:503-386-1377
Practice Address - Street 1:655 MEDICAL CENTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-581-5287
Practice Address - Fax:503-386-1377
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36908207W00000X
ORMD 14288207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR11938-8Medicaid
OR11938-8Medicaid
OR0749690001Medicare NSC
ORR0000BHTMXMedicare PIN