Individual
MR. MICHAEL WAYNE BERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
400 JOHNSON RIDGE RD, ELKIN, NC 28621-2418
(336) 526-4500
(336) 526-8626
Mailing address
400 JOHNSON RIDGE MEDICAL PARK, ELKIN, NC 28621-2447
(336) 526-4500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201050
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003692
—
NC
Enumeration date
01/30/2006
Last updated
07/08/2007
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