Individual
DR. WILLIAM OLIVER BERLIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4121 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1102
(505) 314-0748
Mailing address
4101 BLUE RIDGE PL NE, ALBUQUERQUE, NM 87111-4166
(505) 314-0748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
92-183
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013372
—
NM
01
—
NM019U17
BLUE CROSS BLUE SHIELD
NM
01
—
P00209333
RAILROAD MEDICARE
—
Enumeration date
11/09/2006
Last updated
07/08/2007
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