Berde, Charles B

Berde, Charles B is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Berde, Charles B can be contacted via phone (617) 355-6995.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 54097 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 54097 Massachusetts

Profile Details

NPI number 1356318018
LBN Legal business name Berde, Charles B
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Aug 20th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356318018 NPPES
Massachusetts MEDICAID 6194109

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