Stuart Holland Berryman in Peoria - Medical
Stuart Holland Berryman - NPI 1093774705
Stuart Holland Berryman is a Medical in Peoria, Illinois. Stuart Holland Berryman practices all healthcare services and medical treatments related to Medical. The NPI Number for Stuart Holland Berryman is 1093774705. The last update date is 2007-07-08.
Stuart Holland Berryman's current location address is 4909 N Glen Park Place Rd, Peoria, Illinois. You can contact this provider via phone number 3096747546 and fax number 3092820500. The mailing address for Stuart Holland Berryman is 4909 N Glen Park Place Rd, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stuart Holland Berryman |
|---|---|
| Address | 4909 N Glen Park Place Rd, Peoria, Illinois |
| Phone Number | 3096747546 |
| Fax Number | 3092820500 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1093774705 |
|---|---|
| Provider Enumeration Date | 2006-03-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4909 N Glen Park Place Rd |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616144676 |
| Phone Number | 3096747546 |
| Fax Number | 3092820500 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
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Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
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What is the unique 10-digit identification code assigned to Stuart Holland Berryman by the Centers for Medicare & Medicaid Services?
The Stuart Holland Berryman has been issued the NPI (National Provider Identifier) 1093774705, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Stuart Holland Berryman's physical address?
The Stuart Holland Berryman is physically located at 4909 N Glen Park Place Rd, in the city of Peoria, IL, with the postal code 616144676.
What is the Stuart Holland Berryman's specialty and taxonomy code?
The Stuart Holland Berryman's specialty is Medical, and the corresponding taxonomy code is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1093774705 to Stuart Holland Berryman?
The Stuart Holland Berryman received its 1093774705 assignment from the Centers for Medicare & Medicaid Services on 2006-03-21.
When was the Stuart Holland Berryman's information last updated?
The Stuart Holland Berryman's information was last updated on 2007-07-08.