Provider Demographics
NPI:1053375410
Name:BERCIK, FRANK J (DPM)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:BERCIK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 S WHITE ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2916
Mailing Address - Country:US
Mailing Address - Phone:919-554-0711
Mailing Address - Fax:919-554-1185
Practice Address - Street 1:337 S WHITE ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2916
Practice Address - Country:US
Practice Address - Phone:919-554-0711
Practice Address - Fax:919-554-1185
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC328213EP1101X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
976549OtherUNITED HEALTHCARE
6030640OtherCIGNA HEALTHCARE
NC61578OtherMEDCOST
NC0806POtherBLUECROSSBLUESHIELD OF NC
NCP00265465OtherRAILROAD MEDICARE
NC890806PMedicaid
6030640OtherCIGNA HEALTHCARE
U21987Medicare UPIN