Berman, Blake M

Berman, Blake M is an sole proprietor health care provider with primary practice located at 701 W Plymouth Ave , Deland FL 32720-3236. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Berman, Blake M can be contacted via phone (386) 943-3160.

Contact Information

Primary practice address
701 W Plymouth Ave Deland FL 32720-3236
Phone: (386) 943-3160
Fax: (317) 705-5047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 4301052661 Michigan
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301052661 Michigan
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME97498 Florida

Profile Details

NPI number 1487684239
LBN Legal business name Berman, Blake M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Feb 16th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487684239 NPPES
Michigan MEDICAID 3056378
Michigan MEDICAID 3056387

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