Healthcare Provider Details

I. General information

NPI: 1831181734
Provider Name (Legal Business Name): MEREDITH M BERGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 BROWN'S HILL CT
MIDLOTHIAN VA
23114
US

IV. Provider business mailing address

348 BROWN'S HILL CT
MIDLOTHIAN VA
23114
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-2702
  • Fax: 804-272-9355
Mailing address:
  • Phone: 804-272-2702
  • Fax: 804-272-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0101053537
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: