Healthcare Provider Details

I. General information

NPI: 1740108380
Provider Name (Legal Business Name): GWAN CRITICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 23RD ST NW
WASHINGTON DC
20037-2342
US

IV. Provider business mailing address

PO BOX 2406
INDIANAPOLIS IN
46206-2406
US

V. Phone/Fax

Practice location:
  • Phone: 469-420-5527
  • Fax: 469-262-2163
Mailing address:
  • Phone: 469-420-5527
  • Fax: 469-262-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY BERGER
Title or Position: MD
Credential:
Phone: 469-420-5527