Individual
DR. MATTHEW DAN BERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
112 S HANLEY RD, SUITE 130, CLAYTON, MO 63105-3418
(314) 862-5700
(314) 862-6258
Mailing address
112 S HANLEY RD, SUITE 130, CLAYTON, MO 63105-3418
(314) 862-5700
(314) 862-6258
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2001030176
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157342
BLUE CROSS BLUE SHIELD
MO
01
—
322365426
MEDICARE PTAN
MO
Enumeration date
04/24/2007
Last updated
06/17/2014
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