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Individual

MICHAEL BRIAN BERES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
77 HOSPITAL DR, SUITE 400, LOGAN, WV 25601-3451
(304) 792-1480
(304) 792-1481
Mailing address
PO BOX 116, LOGAN, WV 25601-0116
(304) 792-1480
(304) 792-1481

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20176
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001705979
BLUE CROSS BLUE SHIELD
WV
01
180045749
RR MEDICARE
WV
05
1802361001
WV
01
226977
COVENTRY ADVANDTRA FREEDOM
01
562873
STERLING LIFE
Enumeration date
11/02/2005
Last updated
08/21/2012
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