Provider Demographics
NPI:1144295536
Name:BERKELEY, MALAIKA (MD)
Entity type:Individual
Prefix:DR
First Name:MALAIKA
Middle Name:
Last Name:BERKELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 17TH ST NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30363-1098
Mailing Address - Country:US
Mailing Address - Phone:678-538-6422
Mailing Address - Fax:678-538-6423
Practice Address - Street 1:201 17TH ST NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30363-1098
Practice Address - Country:US
Practice Address - Phone:678-538-6422
Practice Address - Fax:678-538-6423
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2014-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227915-12084P0800X
GA0575822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02555159Medicaid
NY02555159Medicaid
NY399BL1Medicare ID - Type Unspecified