Provider Demographics
NPI:1104980721
Name:DRS. BEREZ & DANIEL, PA
Entity type:Organization
Organization Name:DRS. BEREZ & DANIEL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-721-5283
Mailing Address - Street 1:2225 DEFENSE HWY STE E
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2403
Mailing Address - Country:US
Mailing Address - Phone:410-721-5283
Mailing Address - Fax:410-721-2243
Practice Address - Street 1:2225 DEFENSE HIGHWAY SUITE E
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2403
Practice Address - Country:US
Practice Address - Phone:410-721-5283
Practice Address - Fax:410-721-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD162LMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER