Berg, Kevin Craig

Berg, Kevin Craig is an individual health care provider with primary practice located at 1350 S Seward Meridian Pkwy , Wasilla AK 99654-8332. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Berg, Kevin Craig can be contacted via phone (907) 376-0835.

Contact Information

Primary practice address
1350 S Seward Meridian Pkwy Wasilla AK 99654-8332
Phone: (907) 376-0835
Fax: (907) 376-0843
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 104 Alaska

Profile Details

NPI number 1629247820
LBN Legal business name Berg, Kevin Craig
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2008
Last updated Mar 11th, 2008 - about 16 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 1629247820 NPPES
Alaska MEDICAID OD1144

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