Berg, Robert John

Berg, Robert John is an individual health care provider with primary practice located at 2024 15Th St Suite 500, Meridian MS 39301-4130. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Berg, Robert John can be contacted via phone (601) 482-5174.

Contact Information

Primary practice address
2024 15Th St Suite 500 Meridian MS 39301-4130
Phone: (601) 482-5174
Fax: (601) 482-5175
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 06978 Mississippi

Profile Details

NPI number 1114901063
LBN Legal business name Berg, Robert John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jan 8th, 2008 - about 17 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 1114901063 NPPES
Mississippi MEDICAID 00018061
Mississippi Other 73006066

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