Doctor Name: | MICHAEL EDWARD BERKELEY |
NPI Number: | 1013971134 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 24440 |
Business Practice Address: | 1450 E Valley Rd Suite 201 Basalt, CO - 816218304 |
Business Phone Number: | 9709278611 |
Business Fax Number: | 9709278633 |
Mailing Address: | 1450 E Valley Rd, Suite 201 BASALT |
State: | CO |
Postal Code: | 816218304 |
Phone Number: | 9709278611 |
Fax Number: | 9709278633 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 24440 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |