# JOHN DAVID BERRYMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1396735981
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 0101018540 | VA | — |
| 207V00000X | Obstetrics & Gynecology Physician | 20020275 | NM | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | MD25778 | WA | — |

## Other

- **Enumeration date:** 10/25/2005
- **Last updated:** 09/24/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10013194 | LOVELACE HEALTH PLAN | NM |
| 05 | — | 65653041 | — | NM |
| 01 | — | NM009X99 | HMO OF NEW MEXICO | NM |
| 01 | — | QMYPR0067187 | MOLINA SALUD | NM |