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General NPI Number Information
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NPI Number | 1407960735
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Entity Type | Individual
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Provider Name | BARY M BERGER MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 15195 HEATHCOTE BLVD STE 150
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City | HAYMARKET
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State | VA
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Zip | 20169-6243
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Country | US
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Telephone | 571-284-1430
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Fax | 571-284-1449
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Provider Business Mailing Address
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Address Line | PO BOX 748613
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City | ATLANTA
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State | GA
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Zip | 30384-8613
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Country | US
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Telephone |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101049350
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License Number State | VA
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