Berry, Mark G
Berry, Mark G is an individual health care provider with primary practice located at 800 Kenyon Rd , Fort Dodge IA 50501-5776. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Berry, Mark G can be contacted via phone (515) 574-6840.Contact Information
Primary practice address
800 Kenyon Rd
Fort Dodge IA 50501-5776
Phone: (515) 574-6840
Fax: (515) 576-7726
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 03552 | Iowa |
Profile Details
| NPI number | 1336121938 |
|---|---|
| LBN Legal business name | Berry, Mark G |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Jul 29th, 2015 - about 10 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 | 1336121938 | NPPES |
| Iowa | MEDICAID | 0432666 |
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