Provider Demographics
NPI:1174560312
Name:BERKOMPAS, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:BERKOMPAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-269-4584
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2014-08-01
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Provider Licenses
StateLicense IDTaxonomies
TN17891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1058203OtherCOVENTRY
TN798071OtherUNITED HEALTHCARE
TX10074030OtherAMERIGROUP-TENNCARE
TN3164293OtherBLUE CROSS OF TN
TN4113407OtherAETNA
TN633770OtherUSA MANAGED CARE
TN3482983OtherCIGNA
TN1506399Medicaid
KY64796691Medicaid
TNQ006395Medicaid
TN1100342182OtherUSA PPO-GEHA
TN110217706OtherMEDICARE RR
TX12075822OtherMULTIPLAN/PHCS
KY64796691Medicaid