Michael Richard Berry in Moline - Student In An Organized Health Care Education/training Program
Michael Richard Berry - NPI 1114121969
Michael Richard Berry is a Student In An Organized Health Care Education/training Program in Moline, Illinois. Michael Richard Berry practices all healthcare services and medical treatments related to Student In An Organized Health Care Education/training Program. The NPI Number for Michael Richard Berry is 1114121969. The last update date is 2011-08-15.
Michael Richard Berry's current location address is 520 Valley View Dr, Moline, Illinois. You can contact this provider via phone number 3097623621 and fax number 3097623690. The mailing address for Michael Richard Berry is 520 Valley View Dr, Moline, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Michael Richard Berry |
|---|---|
| Address | 520 Valley View Dr, Moline, Illinois |
| Phone Number | 3097623621 |
| Fax Number | 3097623690 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1114121969 |
|---|---|
| Provider Enumeration Date | 2007-06-14 |
| Last Updated Date | 2011-08-15 |
Provider Mailing Address Detail
| Address | 520 Valley View Dr |
|---|---|
| City | Moline |
| State | Illinois (IL) |
| Post Code | 612656194 |
| Phone Number | 3097623621 |
| Fax Number | 3097623690 |
Provider's Primary Taxonomy Detail
| Speciality | Student In An Organized Health Care Education/training Program |
|---|---|
| Taxonomy | 390200000X |
| Licence No | 2006020074 |
|
Definition: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 578210011 | IA | MEDICARE PTAN | |
| 209395016 | IL | MEDICARE PTAN |
Post Comment/ Review Below
What is the Michael Richard Berry's 1114121969?
The Michael Richard Berry's NPI (National Provider Identifier) Number is 1114121969. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Michael Richard Berry is geographically located?
The Michael Richard Berry is physically situated at the following location: 520 Valley View Dr, Moline, IL, 612656194.
What is Michael Richard Berry's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Michael Richard Berry is Student In An Organized Health Care Education/training Program, and the taxonomy code that classifies this field of practice is 390200000X.
On what date did the Michael Richard Berry receive its 1114121969 assignment from the Centers for Medicare & Medicaid Services?
The Michael Richard Berry was assigned its 1114121969 by the Centers for Medicare & Medicaid Services on 2007-06-14.
As of what date were the Michael Richard Berry's details last updated?
The information pertaining to the Michael Richard Berry, including its address, specialty, and other details, was most recently updated on 2011-08-15.