Individual
JOHN DAVID BERRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
109 VIRGINIA ST, BECKLEY, WV 25801-4349
(202) 270-1001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101018540
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
20020275
NM
207V00000X
Obstetrics & Gynecology Physician
MD25778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10013194
LOVELACE SALUD
NM
05
—
65653041
—
NM
01
—
NM009X99
HMO OF NEW MEXICO
NM
01
—
QMYPR0067187
MOLINA SALUD
NM
Enumeration date
10/25/2005
Last updated
09/24/2007
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