Provider Demographics
NPI:1417594615
Name:BERGER, DOUGLAS MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MARC
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8891 MAJORCA BAY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6925
Mailing Address - Country:US
Mailing Address - Phone:561-434-9774
Mailing Address - Fax:
Practice Address - Street 1:8891 MAJORCA BAY DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6925
Practice Address - Country:US
Practice Address - Phone:561-434-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1431552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry