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General NPI Number Information
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NPI Number | 1760942288
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Entity Type | Individual
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Provider Name | NICHOLAS M BERTHA MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 200 BOWMAN DR STE E100
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City | VOORHEES
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State | NJ
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Zip | 08043-9648
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Country | US
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Telephone | 609-267-9400
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Fax | 856-809-2334
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 401
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 609-267-9400
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Fax | 856-809-2334
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA12757400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0072755
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | DR.0072755
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License Number State | CO
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