Provider Demographics
NPI:1417029067
Name:BERMAN, GREG (MD)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 NW CANAL ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4970
Mailing Address - Country:US
Mailing Address - Phone:206-774-0532
Mailing Address - Fax:206-407-3118
Practice Address - Street 1:1988 BUSH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3205
Practice Address - Country:US
Practice Address - Phone:206-774-0532
Practice Address - Fax:206-407-3118
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA786832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry