MR. MARK WILLIAM BERBAUM (NPI# 1285651141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285651141 |
| Entity Type | Individual |
| Full Name | MR. MARK WILLIAM BERBAUM |
| Credential | MD |
| Practice Address |
4527 Everhard Rd Nw Canton OH 44718 |
| Practice Telephone | 3309663111 |
| Practice Fax Number | 3309661416 |
| Mailing Telephone | 3309663111 |
| Mailing Fax Number | 3309661416 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2013-02-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35056279B | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 070008885 | 01 | |
| WORKERS COMPENSATION | 34180382300 | 01 | |
| ANTHEM BCBS | 000000139234 | 01 |
| Street Address |
4527 EVERHARD RD NW |
| City | CANTON |
| State | OH |
| Zip Code | 44718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750549747 | Mark Berbaum Md Inc | Dermatology | 4527 Everhard Rd Nw, Canton, OH 44718 | 2008-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639658057 | Christine Lynn Mccrone | Psychologist | 4450 Belden Village St Nw Ste 701, Canton, OH 44718 | 2018-08-07 |
| 1295252500 | Dora C Holliday | Student in an Organized Health Care Education/Training Program | 4641 Fulton Dr N.w., Canton, OH 44718 | 2017-08-28 |
| 1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
| 1457710139 | Aria Lg Counseling and Wellness Center, LLC | Clinic/Center | 5262 Fulton Road Nw, Canton, OH 44718 | 2016-02-23 |
| 1457722365 | Melinda R Bond | Nurse Practitioner | 4105 Holiday Street Nw, Canton, OH 44718 | 2015-10-19 |
| 1164804860 | Ashley Marie Whetsell | Dentist | 4550 Belden Village Street Nw, Canton, OH 44718 | 2015-06-18 |
| 1346643749 | Emil D. Poporad, Dds | Dentist | 4124 Fulton Rd. N.w., Suite 102, Canton, OH 44718 | 2014-09-30 |
| 1699198390 | Lauri Sanders | Social Worker | 5860 Fulton Dr Nw, Canton, OH 44718 | 2014-01-31 |
| 1376893768 | Courteney R Briceland | Social Worker | 4641 Fulton Rd. Nw, Canton, OH 44718 | 2012-09-13 |
| 1982953220 | Lyudmyla Z Rockaway | Marriage & Family Therapist | 4895 Dressler Road Nw, Ste A, Canton, OH 44718 | 2012-08-31 |
| Find all providers in zip 44718 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1699982454 | Skin and Allergy Clinic, Inc. | Dermatology | 6801 Graystone Cir Nw, Dr. Khan - Dermatologist, Canton, OH 44718-1372 | 2007-05-17 |
| 1215994470 | Paige Bloodworth Camp | Dermatology | 130 Oakside Ct, Suite A, Canton, GA 30114-2456 | 2006-04-28 |
| 1255398418 | Fausto Antonio Sicard | Dermatology | 4825 Munson St Nw, Canton, OH 44718-3614 | 2006-04-28 |
| 1295704815 | Ann Ammond Lafond | Dermatology | 8584 N Canton Center Rd, Canton, MI 48187-1310 | 2006-03-16 |
| 1235106642 | Maria A Charif | Dermatology | 4340 Fulton Dr Nw, Canton, OH 44718-2824 | 2006-03-03 |
| 1124095682 | Lisa Marie Sayoc | Dermatology | 4565 Dressler Nwrd Ll3, Canton, OH 44718-2579 | 2006-03-03 |
| 1134125065 | Thomas Powell Waldinger | Dermatology | 285 N Lilley Rd, Canton, MI 48187-3907 | 2005-06-24 |
| 1649629510 | Chelsea Luther | Dermatology | 285 N Lilley Rd, Canton, MI 48187-3907 | 2016-06-10 |
| 1336593169 | Kimberly Simons | Dermatology | 285 N Lilley Rd, Canton, MI 48187-3907 | 2016-04-18 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.