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Individual
CHARLES MATS BERRY
Active
Individual
CHARLES MATS BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
RN2264496
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2264496
MA
Other
Enumeration date
03/21/2018
Last updated
09/20/2022
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