MEDICARE: DR. RYAN JOSEPH 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	207X00000X	Orthopaedic Surgery Physician	2020-00132	NC
2	207X00000X	Orthopaedic Surgery Physician	4301501492	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0397730004	OTHER	NC	NSC#

General Provider Information

NPI Number	:	1396139473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN JOSEPH BERGER MD

Provider Business Mailing Address
First Line	:	26211 CENTRAL PARK BLVD STE 201
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-4158
Country	:	US
Telephone Number	:	833-667-3627
Fax Number	:	833-972-5509

Provider Business Practice Location Address
First Line	:	26025 LAHSER RD FL 2
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-2606
Country	:	US
Telephone Number	:	248-663-1900
Fax Number	:	844-598-9633

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

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	07/01/2026

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