Healthcare Provider Details

I. General information

NPI: 1902548167
Provider Name (Legal Business Name): JARED W BERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WOODMEN RD
COLORADO SPRINGS CO
80923-2601
US

IV. Provider business mailing address

6001 E WOODMEN RD
COLORADO SPRINGS CO
80923-2601
US

V. Phone/Fax

Practice location:
  • Phone: 719-571-5000
  • Fax:
Mailing address:
  • Phone: 719-571-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0074794
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: