Healthcare Provider Details

I. General information

NPI: 1932113164
Provider Name (Legal Business Name): DAIVD TOBIAS BERGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 PLEASANT STREET CENTER FOR INTEGRATIVE MEDICINE
CONCORD NH
03301
US

IV. Provider business mailing address

22 S MEADOW ST
CONCORD NH
03301-2258
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number328
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number39176
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2170
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: