Provider Demographics
NPI:1972596773
Name:BERLIN, FREDERICK S (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:S
Last Name:BERLIN
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:FRED
Other - Middle Name:S
Other - Last Name:BERLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:104 E BIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2755
Mailing Address - Country:US
Mailing Address - Phone:410-539-1661
Mailing Address - Fax:410-539-1664
Practice Address - Street 1:104 E BIDDLE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2755
Practice Address - Country:US
Practice Address - Phone:410-539-1661
Practice Address - Fax:410-539-1664
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD187032084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70313Medicare UPIN
MD1574Medicare ID - Type Unspecified