Berg, Kenneth C

Berg, Kenneth C is an individual health care provider with primary practice located at 525 W River Woods Pkwy Ste 100 , Glendale WI 53212-1010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Berg, Kenneth C can be contacted via phone (414) 332-6262.

Contact Information

Primary practice address
525 W River Woods Pkwy Ste 100 Glendale WI 53212-1010
Fax: (414) 332-0422
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 64556 Wisconsin

Profile Details

NPI number 1578981213
LBN Legal business name Berg, Kenneth C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2014
Last updated Jun 25th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578981213 NPPES
Wisconsin MEDICAID 1578981213

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