Individual provider · NPI-1

Dr. Richard Berry, MD

Family Medicine · Mentor, OH

NPI number1346636628
StatusActive
Last updated in NPPESMay 18, 2021

Details

NPI
1346636628
Entity type
Individual (NPI-1)
Name
Dr. Richard Berry
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 13, 2015
Certification date
May 18, 2021
Last updated
May 18, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine35.132533OHYes
390200000X Student in an Organized Health Care Education/Training Program–OH

Practice location

9500 Mentor Ave Ste 100
Mentor, OH 44060

Phone 440-352-4880 · Fax 440-352-3629

Mailing address

9500 Mentor Avenue
Suite 100
Mentor, OH 44060

Phone 440-352-4880 · Fax 440-352-3629

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