Provider Demographics
NPI:1871695908
Name:JOHN F. BERRY, M.D., P.C.
Entity type:Organization
Organization Name:JOHN F. BERRY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:508-775-3177
Mailing Address - Street 1:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-0666
Mailing Address - Country:US
Mailing Address - Phone:508-775-3177
Mailing Address - Fax:508-775-0895
Practice Address - Street 1:1949 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-3119
Practice Address - Country:US
Practice Address - Phone:508-775-3177
Practice Address - Fax:508-775-0895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9746463Medicaid
MA9746463Medicaid