MEDICARE: STEFAN BERGER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	145164	NY

General Provider Information

NPI Number	:	1043328446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFAN BERGER MD

Provider Business Mailing Address
First Line	:	12170 BEAR RIVER RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33473-4970
Country	:	US
Telephone Number	:	561-571-1177
Fax Number	:	561-200-0478

Provider Business Practice Location Address
First Line	:	12170 BEAR RIVER RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33473-4970
Country	:	US
Telephone Number	:	561-571-1177
Fax Number	:	561-200-0478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2006
Last Update Date	:	11/24/2015

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