MEDICARE: ROBERT A BERGER M.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	208600000X	Surgery Physician	25665	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	Z81338	OTHER	AZ	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1417926874	OTHER	AZ	AETNA
2	1417926874	OTHER	AZ	HUMANA
3	1417926874	OTHER	AZ	AZFMC
4	1417926874	OTHER	AZ	CIGNA
5	1417926874	OTHER	AZ	UHC
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	AZ0755200	OTHER	AZ	BLUE CROSS BLUE SHIELD AZ

General Provider Information

NPI Number	:	1417926874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A BERGER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31210
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86003-1210
Country	:	US
Telephone Number	:	928-773-2222
Fax Number	:	928-773-2598

Provider Business Practice Location Address
First Line	:	77 W FOREST AVE STE 201
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1483
Country	:	US
Telephone Number	:	928-773-2222
Fax Number	:	928-773-2598

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	10/12/2020

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Directions to “ ROBERT A BERGER M.D.” Practice Location

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