Healthcare Provider Details

I. General information

NPI: 1124657515
Provider Name (Legal Business Name): TRISTON WIHELM GABRIEL BERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORWALK HOSPITAL 34 MAPLE STREET
NORWALK CT
06856-3815
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2025
  • Fax: 203-899-5224
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number82339
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number82339
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: