Individual
MATTHEW BERCHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3409 WORTH ST, 300, DALLAS, TX 75246-2029
(214) 865-1350
(214) 865-1351
Mailing address
3409 WORTH ST, 300, DALLAS, TX 75246-2029
(214) 865-1350
(214) 865-1351
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
P0957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009934598
—
AL
05
—
009941273
—
AL
01
—
051531430
BLUE CROSS OF ALABAMA
AL
01
—
051531832
BLUE CROSS OF ALABAMA
AL
05
—
3125627-02
—
TX
Enumeration date
05/17/2006
Last updated
06/25/2013
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