Provider Demographics
NPI:1124182100
Name:TOEWS, BERTON JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BERTON
Middle Name:JAMES
Last Name:TOEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-3764
Mailing Address - Country:US
Mailing Address - Phone:307-259-4884
Mailing Address - Fax:307-242-5050
Practice Address - Street 1:4911 E 16TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-3764
Practice Address - Country:US
Practice Address - Phone:307-259-4884
Practice Address - Fax:307-242-5050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYA2627A207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1064517000Medicaid
WYA72971Medicare UPIN