Provider Demographics
NPI:1982449955
Name:BERIKA, LINA
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:BERIKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0006
Mailing Address - Country:US
Mailing Address - Phone:706-721-3229
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH ST DEPT OF
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0006
Practice Address - Country:US
Practice Address - Phone:706-721-3229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16806208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics