Berg, Russell David

Berg, Russell David is an individual health care provider with primary practice located at 325 9Th Ave , Seattle WA 98104-2420. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Berg, Russell David can be contacted via phone (206) 520-5000.

Contact Information

Primary practice address
325 9Th Ave Seattle WA 98104-2420
Phone: (206) 520-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X MD60888448 Washington
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD60888448 Washington

Profile Details

NPI number 1427412899
LBN Legal business name Berg, Russell David
Credentials M.D. PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2016
Last updated Apr 29th, 2019 - about 7 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 1427412899 NPPES
Washington MEDICAID 1427412899

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