Richard C Berg Jr., MD
Surgery in Lafayette, IN. Individual provider (NPI-1).
NPI number1124097977
StatusActive
Last updated in NPPESFeb 1, 2021
Details
- NPI
- 1124097977
- Entity type
- Individual (NPI-1)
- Name
- Richard C Berg Jr.
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2006
- Certification date
- Feb 1, 2021
- Last updated
- Feb 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 01056973A | IN | Yes |
Practice location
2600 Greenbush StLafayette, IN 47904-2479
Phone 765-448-8000 · Fax 765-448-8027
Mailing address
1200 W White River BlvdMuncie, IN 47303-4988
Phone 877-668-5621
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