Provider Demographics
NPI:1356839427
Name:BERGER, STEPHEN LAWRENCE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LAWRENCE
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NORTH WOLFE STREET
Mailing Address - Street 2:MEYER 6-181
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-502-0133
Mailing Address - Fax:410-502-6737
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:MEYER 6-181
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-502-0133
Practice Address - Fax:410-502-6737
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD936602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology