Berg, Sara A

Berg, Sara A is an sole proprietor health care provider with primary practice located at 1623 5Th St Suite B, Clarkston WA 99403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Berg, Sara A can be contacted via phone (509) 758-0128.

Contact Information

Primary practice address
1623 5Th St Suite B Clarkston WA 99403
Phone: (509) 758-0128
Fax: (509) 758-0402
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD00029192 Washington
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M5872 Idaho

Profile Details

NPI number 1417941006
LBN Legal business name Berg, Sara A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2005
Last updated Jun 29th, 2010 - about 15 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 1417941006 NPPES
Idaho Other 58727 BLUE CROSS OF IDAHO
Idaho Other 152174XX BLUE CROSS OF IDAHO
Idaho Other 3083164231BERSA BLUE CROSS OF IDAHO
Idaho MEDICAID 1067362 BLUE CROSS OF IDAHO
Idaho Other 000010004632 BLUE CROSS OF IDAHO
Idaho Other 0005356454 BLUE CROSS OF IDAHO
Idaho MEDICAID 002685500 BLUE CROSS OF IDAHO
Idaho Other 2005013110402042 BLUE CROSS OF IDAHO

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