Provider Demographics
NPI:1003367426
Name:BERG, ALAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:BERG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4014 RIVER RD
Mailing Address - Street 2:BUILDING 3B
Mailing Address - City:EAST CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2916
Mailing Address - Country:US
Mailing Address - Phone:810-329-4779
Mailing Address - Fax:810-329-7860
Practice Address - Street 1:4014 RIVER RD
Practice Address - Street 2:BUILDING 3B
Practice Address - City:EAST CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-2916
Practice Address - Country:US
Practice Address - Phone:810-329-4779
Practice Address - Fax:810-329-7860
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
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Provider Licenses
StateLicense IDTaxonomies
MI4301111128208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery