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
Fax: (515) 576-7726
Website:

Health care specialties

SpecialtyCodeLicense #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 9 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 1336121938 NPPES
Iowa MEDICAID 0432666

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