Individual
DR. DONALD BLAKE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
176 THOMAS JOHNSON DR, SUITE 204, FREDERICK, MD 21702-4410
(301) 620-4100
(301) 620-1407
Mailing address
604 SOLAREX CT, UNIT 205, FREDERICK, MD 21703-8655
(301) 620-4100
(301) 620-1407
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01420
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223239
MAMSI
—
01
—
3831919
CIGNA
—
01
—
KP25BE
CAREFIRST BCBS MARYLAND
MD
01
—
W375-0001
CAREFIRST BCBS FEP
—
Enumeration date
11/07/2005
Last updated
03/27/2017
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