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Individual

DR. MICHAEL P BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
Mailing address
7714 POPLAR AVE STE 200, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 685-2969

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
36377
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07836597
MS
01
1031029981
MEDICARE MS
MS
01
103I917534
MEDICARE TN
TN
05
126787001
AR
05
1529828
TN
Enumeration date
08/28/2006
Last updated
10/23/2020
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