Provider Demographics
NPI:1508391160
Name:BERGER, ANTHONY PETER (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:PETER
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 1:1148 WASHINGTON AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7728
Mailing Address - Country:US
Mailing Address - Phone:616-499-4844
Mailing Address - Fax:616-499-4847
Practice Address - Street 1:1148 WASHINGTON AVE STE 20
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7728
Practice Address - Country:US
Practice Address - Phone:616-499-4844
Practice Address - Fax:616-499-4847
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01086101A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology