Doctor Name: | DR. BRION ALAN BERTSCH |
NPI Number: | 1487660981 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01031910A |
Business Practice Address: | 9260 E 1125 S Fairmount, IN - 469289585 |
Business Phone Number: | 7659982708 |
Business Fax Number: | |
Mailing Address: | 9260 E 1125 S, FAIRMOUNT |
State: | IN |
Postal Code: | 469289585 |
Phone Number: | 7659982708 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 09/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 01031910A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |