Individual
ANDREW R BERKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 NAVARRE PL STE 6600, SOUTH BEND, IN 46601-1173
(574) 647-8800
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
02002525A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300048038
—
IN
01
—
M32727010
MEDICARE PTAN
IN
Enumeration date
02/10/2006
Last updated
04/26/2021
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