Berke, Ethan Michael
Berke, Ethan Michael is an individual health care provider with primary practice located at 18 Old Etna Rd Dhmc - Department Of Community And Family Medicine, Lebanon NH 03766. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Berke, Ethan Michael can be contacted via phone (603) 650-4000.Contact Information
Primary practice address
18 Old Etna Rd Dhmc - Department Of Community And Family Medicine
Lebanon NH 03766
Phone: (603) 650-4000
Fax: (603) 650-4198
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00035349 | Washington |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 13084 | New Hampshire |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 63043 | Minnesota |
Profile Details
| NPI number | 1902858855 |
|---|---|
| LBN Legal business name | Berke, Ethan Michael |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Oct 10th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902858855 | NPPES |
| Vermont | MEDICAID | 1012802 | |
| Vermont | MEDICAID | 30206160 |
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