Basic Information
Provider Information
NPI: 1003004391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALKER
FirstName: DAVID
MiddleName: BERMAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10625 CALHOUN RD
Address2: PO BOX 12034
City: OMAHA
State: NE
PostalCode: 681121324
CountryCode: US
TelephoneNumber: 4024571300
FaxNumber: 4024571403
Practice Location
Address1: 10625 CALHOUN RD
Address2:  
City: OMAHA
State: NE
PostalCode: 681121324
CountryCode: US
TelephoneNumber: 4024571300
FaxNumber: 4024571403
Other Information
ProviderEnumerationDate: 10/11/2007
LastUpdateDate: 10/11/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X20478NEY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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