Provider Demographics
NPI:1609996115
Name:BERG, WILLIAM F (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:BERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 STATE ROUTE 34 STE B
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2151
Mailing Address - Country:US
Mailing Address - Phone:732-290-2288
Mailing Address - Fax:732-290-2660
Practice Address - Street 1:1077 STATE ROUTE 34 STE B
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2151
Practice Address - Country:US
Practice Address - Phone:732-290-2288
Practice Address - Fax:732-290-2660
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor