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General NPI Number Information
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NPI Number | 1386688851
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Entity Type | Individual
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Provider Name | ROBERT BERGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 434 CONFEDERATE DR
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City | CLAYTON
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State | GA
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Zip | 30525-5319
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Country | US
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Telephone | 855-687-7237
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Fax | 423-778-6261
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Provider Business Mailing Address
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Address Line | 22100 BOTHELL EVERETT HWY
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City | BOTHELL
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State | WA
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Zip | 98021-8431
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Country | US
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Telephone | 208-416-2932
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 38675
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101265049
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 33029
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License Number State | GA
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