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NPI Code Detail

MEDICARE: DR. BRUCE JEFFREY BERG M.D.

MEDICARE:  DR. BRUCE JEFFREY BERG  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
12084P0800XPsychiatry PhysicianMD-037544-EPA
22084P0800XPsychiatry PhysicianC1-0003974DE
32084P0802XAddiction Psychiatry PhysicianMD-037544-EPA
42084P0800XPsychiatry PhysicianMD037544EPA

General Provider Information

NPI Number : 1932279718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE JEFFREY BERG M.D.
Provider Business Mailing Address
First Line : 2000 FOULK RD
Second Line : SUITE A
City : WILMINGTON
State : DE
Zip : 19810-3642
Country : US
Telephone Number : 610-527-6555
Fax Number :
Provider Business Practice Location Address
First Line : 2000 FOULK RD
Second Line : SUITE A
City : WILMINGTON
State : DE
Zip : 19810-3642
Country : US
Telephone Number : 610-527-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 04/19/2016

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Directions to “ DR. BRUCE JEFFREY BERG M.D.” Practice Location

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