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
Phone: (414) 332-6262
Fax: (414) 332-0422
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578981213 | NPPES |
| Wisconsin | MEDICAID | 1578981213 |
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