Individual
MATTHEW GLEN BERARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3208 HUSKY HWY, FARMINGTON, WV 26571-8122
(304) 825-6364
(304) 825-6750
Mailing address
3208 HUSKY HWY, FARMINGTON, WV 26571-8122
(304) 825-6364
(304) 825-6750
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
830-D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810007303
—
WV
Enumeration date
11/22/2006
Last updated
07/21/2022
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