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General NPI Number Information
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NPI Number | 1851504518
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Entity Type | Individual
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Provider Name | JOSHUA BRADLEY BERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 11455 N MERIDIAN ST STE 200
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City | CARMEL
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State | IN
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Zip | 46032-1680
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Country | US
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Telephone | 317-582-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 11455 N MERIDIAN ST STE 200
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City | CARMEL
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State | IN
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Zip | 46032-1680
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | M9854
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 01091787A
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License Number State | IN
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