Healthcare Provider Details

I. General information

NPI: 1972665834
Provider Name (Legal Business Name): SIGRID E BERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WHITING HILL RD SUITE 21
BREWER ME
04412-1021
US

IV. Provider business mailing address

43 WHITING HILL RD SUITE 300
BREWER ME
04412-1005
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7478
  • Fax: 207-973-8234
Mailing address:
  • Phone:
  • Fax: 207-973-8234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMT186411
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD426107
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number017706
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: