Individual
DR. MICHAEL S BERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5180 E MAIN ST, COLUMBUS, OH 43213
(614) 866-9002
(614) 866-3581
Mailing address
943 JOHNSTOWN RD, GAHANNA, OH 43230
(614) 476-2015
(614) 428-9856
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3660T353
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11478366
CAQH
—
Enumeration date
07/10/2006
Last updated
11/18/2009
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