Geoffrey Herbst Berg, MD
Internal Medicine in Providence, RI. Individual provider (NPI-1).
NPI number1902804313
StatusActive
Last updated in NPPESJun 6, 2012
Details
- NPI
- 1902804313
- Entity type
- Individual (NPI-1)
- Name
- Geoffrey Herbst Berg
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 9, 2005
- Last updated
- Jun 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 05035 | RI | Yes |
Practice location
160 Wayland AveProvidence, RI 02906-4304
Phone 401-521-1221 · Fax 401-454-4189
Mailing address
160 Wayland AveProvidence, RI 02906-4304
Phone 401-521-1221 · Fax 401-454-4189
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