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MARY JEAN BERG MD

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1245372648

Individual Registrant:
 MARY JEAN BERG MD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1100 CARSON AVE  LA JUNTA, CO 81050-2751 US
Tel: 800-893-9698  Fax: --

Contact information for business:
200 CORPORATE BLVD SUITE 201 LAFAYETTE, LA 70508-3870 US
Tel: --  Fax: --

Registration Information:
NPI: 1245372648
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
CO17415

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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