Provider Demographics
NPI:1215125349
Name:BERKOWITZ, MARC ADAM (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:ADAM
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:88 CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2700
Mailing Address - Country:US
Mailing Address - Phone:440-735-3338
Mailing Address - Fax:440-735-8234
Practice Address - Street 1:88 CENTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2700
Practice Address - Country:US
Practice Address - Phone:440-735-3338
Practice Address - Fax:440-735-8234
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003471213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist