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Individual

BORIS BEREJAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200601041
NC
207P00000X
Emergency Medicine Physician
38470
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144KK
BCBS
NC
05
32331700
WI
05
5906740
NC
01
P00229728
MEDICARE RAILROAD
WI
01
P00268123
MEDICARE RAILROAD
WI
05
Q0104F
SC
Enumeration date
04/04/2006
Last updated
01/18/2011
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