MEDICARE: KRISTA BERGER PA-C

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	363AS0400X	Surgical Physician Assistant	50-003656	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891049250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA BERGER PA-C

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-7399
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 KENNY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3503
Country	:	US
Telephone Number	:	614-293-7399
Fax Number	:

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

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	09/07/2023

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Directions to “ KRISTA BERGER PA-C” Practice Location

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