Individual
DR. STEVEN L BERKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
006728
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
006728
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004083333
—
CT
01
—
020006728CT01
BC/BS PROVIDER ID #
CT
01
—
190000670
MEDICARE
CT
01
—
5477144
AETNA MEDICAL PROVIDER ID
CT
Enumeration date
09/12/2005
Last updated
09/30/2013
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