Individual
KATHERINE REBECCA BERWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2700 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-9494
(919) 731-6060
(919) 580-9183
Mailing address
PO BOX K, GOLDSBORO, NC 27533-9710
(919) 580-0004
(919) 580-9224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-07710
NC
363A00000X
Physician Assistant
Primary
57931
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-07710
NC MEDICAL LICENSE
NC
Enumeration date
08/30/2017
Last updated
08/03/2023
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