Healthcare Provider Details

I. General information

NPI: 1083661417
Provider Name (Legal Business Name): KARL BERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 FRANKLIN ST FRANKLIN STREET PEDIATRICS
JOHNSTOWN PA
15905
US

IV. Provider business mailing address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

V. Phone/Fax

Practice location:
  • Phone: 814-536-8956
  • Fax: 814-539-6601
Mailing address:
  • Phone: 814-410-8300
  • Fax: 814-410-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD016219E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: