Individual
DR. ETHAN MICHAEL BERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
18 OLD ETNA RD, DHMC - DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE, LEBANON, NH 03766
(603) 650-4000
(603) 650-4198
Mailing address
1 MEDICAL CENTER DR, DHMC - DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE, LEBANON, NH 03756-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13084
NH
207Q00000X
Family Medicine Physician
Primary
63043
MN
207Q00000X
Family Medicine Physician
MD00035349
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012802
—
VT
05
—
30206160
—
NH
Enumeration date
05/17/2006
Last updated
10/10/2022
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