Basic Information
Provider Information
NPI: 1487731584
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERGER
FirstName: ROBERT
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 143 W FRANKLIN ST
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275162539
CountryCode: US
TelephoneNumber: 9199664996
FaxNumber:  
Practice Location
Address1: 101 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275990001
CountryCode: US
TelephoneNumber: 9199664131
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 07/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X20876NCY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
11012496401NCRAIL ROAD MEDICAREOTHER
891514305NC MEDICAID


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