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General NPI Number Information
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NPI Number | 1366562944
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW PEDIATRICS
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 77 W FOREST AVE STE 304
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1481
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Country | US
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Telephone | 928-214-3600
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Fax | 928-214-3601
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Provider Business Mailing Address
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Address Line | 77 W FOREST AVE STE 304
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1481
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Country | US
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Telephone | 928-214-3600
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Fax | 928-214-3601
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY A BERGER
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Credential | MD
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Telephone | 928-214-3600
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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 |
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License Number State |
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