Provider Demographics
NPI:1982791950
Name:BERKELEY, BARBARA ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:BERKELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15536 HEMLOCK POINT RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3838
Mailing Address - Country:US
Mailing Address - Phone:440-247-0463
Mailing Address - Fax:440-893-0683
Practice Address - Street 1:5192 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4196
Practice Address - Country:US
Practice Address - Phone:449-338-6009
Practice Address - Fax:440-338-3336
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055316B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHD69045Medicare UPIN