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General NPI Number Information
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NPI Number | 1790062347
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Entity Type | Organization
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Legal Business Name | NATHAN G. BERGER, M.D.,P.A.
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 200 E 33RD ST SUITE 470
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City | BALTIMORE
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State | MD
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Zip | 21218-3322
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Country | US
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Telephone | 410-554-2683
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Fax | 410-554-2900
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Provider Business Mailing Address
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Address Line | 200 E 33RD ST SUITE 470
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City | BALTIMORE
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State | MD
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Zip | 21218-3322
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Country | US
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Telephone | 410-554-2683
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Fax | 410-554-2900
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATAHN G BERGER
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Credential | M.D.
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Telephone | 410-554-2683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | D23905
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License Number State | MD
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