Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL CONRAD BERRY, RCP, RN
ActiveMR. MICHAEL CONRAD BERRY, RCP, RN is a 2279G1100X healthcare provider located in ST. LOUIS, Missouri. NPI 1831816511 is currently active in the NPPES registry. Verify at CMS.
2279G1100X · ST. LOUIS, MO
Registration Details
- NPI Number
- 1831816511
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 24, 2022 (3.8199431408662 yrs)
- Last Updated
- Oct 24, 2022
- Licenses
-
2004004424 (MO)041494547 (IL)100275 (MO)
Practice Information
- Address
-
3933 SOUTH BROADWAYST. LOUIS, MO, 631184626Browse MO providers · Browse ZIP 63118
- Phone
- 3148657034
- Fax
- 3148657018
- Primary Specialty
-
2279G1100X
2279G1100X
- Additional Specialty
- Registered Nurse
- Additional Specialty
- 2279G1100X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.