Provider Demographics
NPI:1083690101
Name:BERKE, REBECCA G (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:G
Last Name:BERKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 ELDERBERRY ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9446
Mailing Address - Country:US
Mailing Address - Phone:619-545-1148
Mailing Address - Fax:619-767-7417
Practice Address - Street 1:COMNAVAIRFOR
Practice Address - Street 2:BOX 357051 NAS NI
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92135-7051
Practice Address - Country:US
Practice Address - Phone:619-545-1148
Practice Address - Fax:619-767-7417
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000248862083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine