Antoinette Berry

Individual provider Active NPI Other Technician · Brownstown TWP, MI

NPI 1871950451 · NPPES record last updated Jan 27, 2016

Key facts

NPI
1871950451
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
27064 Starkey LN
Brownstown TWP, MI 48174-8501
Phone
(313) 995-5476
NPI assigned
Jan 27, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

27064 Starkey LN
Brownstown TWP, MI 48174-8501

Mailing address

27064 Starkey LN
Brownstown TWP, MI 48174-8501
Phone (313) 995-5476

Other providers in Brownstown TWP, MI

All providers in Brownstown TWP, MI · Other Technician in Michigan

Sources for this page

Verify at the official NPI Registry.