MEDICARE: DR. THOMAS E BERGER PH.D.

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	103TC0700X	Clinical Psychologist	PL 5630	CA

General Provider Information

NPI Number	:	1083613723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS E BERGER PH.D.

Provider Business Mailing Address
First Line	:	230 DUNCAN DR BLDG 440
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31409-5107
Country	:	US
Telephone Number	:	912-315-6430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 HARMON AVE
Second Line	:	STE 1D03
City	:	FT STEWART
State	:	GA
Zip	:	31314-5604
Country	:	US
Telephone Number	:	912-435-6100
Fax Number	:

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	11/02/2010

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