Individual
DR. MICHAEL BRANDON BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 W ARLINGTON BLVD STE 210, GREENVILLE, NC 27834-5758
(252) 752-5000
(252) 931-7694
Mailing address
PO BOX 30750, GREENVILLE, NC 27833-0750
(252) 752-5000
(252) 931-7694
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
200501463
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
200501463
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1411C
—
NC
01
—
1881612000
BLUE CROSS BLUE SHIELD NORTH CAROLINA
NC
Enumeration date
07/17/2006
Last updated
09/01/2016
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