Individual
MR. KEITH T BERSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
320 LILLINGTON AVE STE 101, CHARLOTTE, NC 28204-3189
(704) 362-4403
(704) 362-4405
Mailing address
320 LILLINGTON AVE STE 101, CHARLOTTE, NC 28204-3189
(704) 362-4403
(704) 362-4405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08047
NC
363A00000X
Physician Assistant
52639
CA
Other
Enumeration date
08/07/2015
Last updated
09/16/2021
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