MEDICARE: DR. JOSEPH BERGER MD, RPH

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	2084P0800X	Psychiatry Physician	047397	GA

General Provider Information

NPI Number	:	1164526117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH BERGER MD, RPH

Provider Business Mailing Address
First Line	:	1 DUNWOODY PARK
Second Line	:	SUITE # 140
City	:	ATLANTA
State	:	GA
Zip	:	30338-7404
Country	:	US
Telephone Number	:	770-730-8912
Fax Number	:	770-390-0877

Provider Business Practice Location Address
First Line	:	1 DUNWOODY PARK
Second Line	:	SUITE # 140
City	:	ATLANTA
State	:	GA
Zip	:	30338-7404
Country	:	US
Telephone Number	:	770-730-8912
Fax Number	:	770-390-0877

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

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	08/27/2014

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