Organization
EDWARD W. BERRY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD W BERRY M.D. (PRESIDENT)
(801) 387-3900
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD STE 3680, OGDEN, UT 84403-3289
(801) 387-3900
Mailing address
1652 WILDCAT LN # 1, OGDEN, UT 84403-3236
(801) 393-2249
(801) 393-9909
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498622472004
—
UT
Enumeration date
05/09/2007
Last updated
04/28/2008
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