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General NPI Number Information
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NPI Number | 1083712558
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Entity Type | Individual
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Provider Name | ROBERT ERIC BERG MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 528 SE OSCEOLA ST 2ND FLOOR
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City | STUART
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State | FL
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Zip | 34994
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Country | US
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Telephone | 772-287-3020
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Fax | 772-282-9562
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Provider Business Mailing Address
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Address Line | 3357 SW VILLA PLACE
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City | PALM CITY
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State | FL
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Zip | 34990
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Country | US
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Telephone | 772-283-4014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME71748
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License Number State | FL
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