Basic Information
| Provider Information | |||||||||
| NPI: | 1013985316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERTE | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6900 PEARL RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441303639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408450900 | ||||||||
| FaxNumber: | 4408457355 | ||||||||
| Practice Location | |||||||||
| Address1: | 6900 PEARL RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441303639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408450900 | ||||||||
| FaxNumber: | 4408457355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 01032173A | IN | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 35053503B | OH | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 0629136 | 05 | OH | MEDICAID |