Bertherman, George D
Bertherman, George D is an individual health care provider with primary practice located at 1466 Broad St , Providence RI 02905-2836. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bertherman, George D can be contacted via phone (401) 941-6221.Contact Information
Primary practice address
1466 Broad St
Providence RI 02905-2836
Phone: (401) 941-6221
Fax: (401) 941-6227
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODTG00481 | Rhode Island |
Profile Details
| NPI number | 1629074141 |
|---|---|
| LBN Legal business name | Bertherman, George D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Apr 1st, 2008 - about 18 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629074141 | NPPES |
| Rhode Island | MEDICAID | GB25798 |
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