Individual
DR. JAMES EDWARD BERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7040 N PORT WASHINGTON RD, SUITE 404, GLENDALE, WI 53217-3885
(414) 355-2405
(414) 355-6460
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27925
WI
207ND0101X
MOHS-Micrographic Surgery Physician
27925
WI
207NP0225X
Pediatric Dermatology Physician
27925
WI
207NS0135X
Procedural Dermatology Physician
27925
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31392100
—
WI
01
—
391130058
TAX ID#
WI
01
—
52DO946226
CLIA
WI
Enumeration date
05/10/2006
Last updated
10/12/2022
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