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Individual

PHILIP TODD BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
RR 2 BOX 615A, SCARBRO, WV 25917-9784
(304) 388-2525
(304) 388-2537
Mailing address
RR 2 BOX 615A, SCARBRO, WV 25917-9784
(304) 388-2525
(304) 388-2537

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2120
WV
207Q00000X
Family Medicine Physician
34.012389
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0181970
OH
05
3810010455
WV
Enumeration date
04/23/2007
Last updated
12/27/2016
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