Individual
DR. IRA CHARLES BERKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2019 GALISTEO ST, J-1, SANTA FE, NM 87505-2143
(505) 820-0446
(505) 820-6142
Mailing address
2019 GALISTEO ST, J-1, SANTA FE, NM 87505-2143
(505) 820-0446
(505) 820-6142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82-167
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18689
—
NM
Enumeration date
07/11/2007
Last updated
03/21/2014
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