Basic Information
| Provider Information | |||||||||
| NPI: | 1497884654 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERLINER | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8035 PROVIDENCE RD | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282779716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045423988 | ||||||||
| FaxNumber: | 8555290584 | ||||||||
| Practice Location | |||||||||
| Address1: | 8035 PROVIDENCE RD | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282779716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045423988 | ||||||||
| FaxNumber: | 8555290584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 09/20/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 2010-01017 | NC | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 1497884654 | 01 | NC | INDIVIDUAL NPI | OTHER |