| Doctor Name: | CHARLES R BERRYMAN |
| NPI Number: | 1689630204 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 09919 |
| Business Practice Address: | 950 Matthew Drive Waynesboro, MS - 39367 |
| Business Phone Number: | 6017357102 |
| Business Fax Number: | 6017357168 |
| Mailing Address: | 950 Matthew Drive, P O Box 1249 WAYNESBORO |
| State: | MS |
| Postal Code: | 39367 |
| Phone Number: | 6017357102 |
| Fax Number: | 6017357168 |
| NPI Enumeration Date: | 04/22/2006 |
| NPI Last Update Date: | 11/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 09919 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |