Individual
MR. MARK WILLIAM BERBAUM
Active
Individual
MR. MARK WILLIAM BERBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35056279B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139234
ANTHEM BCBS
—
01
—
070008885
RAILROAD MEDICARE
—
01
—
34180382300
WORKERS COMPENSATION
—
Enumeration date
07/16/2006
Last updated
02/20/2013
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