Doctor Name: | MRS. ELIZABETH ANNE BERLIN |
NPI Number: | 1043579402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | |
Business Practice Address: | 8825 Mall Parkway Suite 150 Lithonia, GA - 30038 |
Business Phone Number: | 7704823241 |
Business Fax Number: | |
Mailing Address: | 8825 Mall Parkway, Suite 150 LITHONIA |
State: | GA |
Postal Code: | 30038 |
Phone Number: | 7704823241 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2012 |
NPI Last Update Date: | 05/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |