Individual
MICHAEL A. BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 CRYSTAL SPRING AVENUE, ROANOKE, VA 24016
(540) 224-5170
(540) 983-8229
Mailing address
2001 CRYSTAL SPRING AVENUE, ROANOKE, VA 24016
(540) 224-5170
(540) 983-8229
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
0101040655
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5842638
—
VA
05
—
5850312
—
VA
05
—
5858666
—
VA
Enumeration date
11/18/2005
Last updated
08/11/2011
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