Provider Demographics
NPI:1003014911
Name:BERGER, JOHN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:BERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 E 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1674
Mailing Address - Country:US
Mailing Address - Phone:402-250-6427
Mailing Address - Fax:
Practice Address - Street 1:6767 29TH ST FL 2
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5474
Practice Address - Country:US
Practice Address - Phone:970-624-2414
Practice Address - Fax:970-490-4155
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN54798207RC0200X, 207R00000X
CODR.007020207RP1001X
IA4095207R00000X
NE675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine