Andrea Lynn Bershow, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

53277 Issued in MN

Practice address

516 Delaware St SE
4-240, Phillips-Wangensteen BLDG.
Minneapolis, MN 55455-0356

Phone

(612) 625-8625

Fax

(612) 624-6678

NPI assigned

Jun 19, 2007

Last updated

Oct 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Andrea Lynn Musel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1013112036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "DEPARTMENT OF DERMATOLOGY- MMC 98",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550392",
            "telephone_number": "612-625-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "4-240, PHILLIPS-WANGENSTEEN BLDG.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-625-8625",
            "fax_number": "612-624-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSHOW",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "25727",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "53277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MUSEL",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shalanda Shawntae Berry, CHW
• Susan Amelia Berry, M.D.
• Christy Berryhill, FNP
• Michael Berryman, MD
• Thomas N Berscheid, MD
• Laura Berskow, CMT
• Nathan Bertelsen, MD
• Joy Amarah Berthelsen, OTD
• Stefan Christian Bertog, MD
• Mario Jonathan Bertogliat, MD

• Dermatology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.