Doctor Name: | DR. BRIAN MEYERBERG |
NPI Number: | 1407845142 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | MD002137 |
Business Practice Address: | 75 Lacey Rd Suite 3 Whiting, NJ - 087592938 |
Business Phone Number: | 7328491115 |
Business Fax Number: | 7328491064 |
Mailing Address: | 75 Lacey Rd, Suite 3 WHITING |
State: | NJ |
Postal Code: | 087592938 |
Phone Number: | 7328491115 |
Fax Number: | 7328491064 |
NPI Enumeration Date: | 10/15/2005 |
NPI Last Update Date: | 11/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | MD002137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |