Basic Information
| Provider Information | |||||||||
| NPI: | 1659374460 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4225 ALTAMONT PL | ||||||||
| Address2: | UNIT # / 3RD FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206953063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018431600 | ||||||||
| FaxNumber: | 3016454734 | ||||||||
| Practice Location | |||||||||
| Address1: | 4225 ALTAMONT PL | ||||||||
| Address2: | UNIT # / 3RD FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206953063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018431600 | ||||||||
| FaxNumber: | 3016454734 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 12/21/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | D30976 | MD | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.