MEDICARE: MOUNTAIN VIEW PEDIATRICS

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1366562944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW PEDIATRICS

Provider Business Mailing Address
First Line	:	77 W FOREST AVE STE 304
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1481
Country	:	US
Telephone Number	:	928-214-3600
Fax Number	:	928-214-3601

Provider Business Practice Location Address
First Line	:	77 W FOREST AVE STE 304
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1481
Country	:	US
Telephone Number	:	928-214-3600
Fax Number	:	928-214-3601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARY A BERGER
Credential	:	MD
Telephone Number	:	928-214-3600

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	10/30/2023

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Directions to “MOUNTAIN VIEW PEDIATRICS ” Practice Location

Language	Start Address	Practice Location

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