# WALLACE P BERKOWITZ MD LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952387516
- **Authorized official:** WALLACE P BERKOWITZ MD (PRESIDENT OWNER)
- **Authorized official phone:** (314) 647-8895

## Contact information

- **Practice address:** 6651 CHIPPEWA, STE 324, ST LOUIS, MO 63109-2538
- **Practice address phone:** (314) 647-8895
- **Practice address fax:** (314) 647-8898
- **Mailing address:** 6651 CHIPPEWA, STE 324, ST LOUIS, MO 63109-2538
- **Mailing address phone:** (314) 647-8895
- **Mailing address fax:** (314) 647-8898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | R4234 | MO | — |
| 207Y00000X | Otolaryngology Physician | — | IL | Yes |

## Other

- **Enumeration date:** 12/15/2005
- **Last updated:** 04/20/2008