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General NPI Number Information
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NPI Number | 1275952376
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Entity Type | Individual
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Provider Name | KATHERINE BECKETT BERGER MD
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Gender | Female
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 1201 LAKE JAMES DR STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6780
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Country | US
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Telephone | 757-523-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 LAKE JAMES DR STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6780
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Country | US
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Telephone | 757-523-0022
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 28142
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101261785
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License Number State | VA
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