Provider Demographics
NPI:1659374460
Name:BERGER, ROBERT S (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4225 ALTAMONT PL
Mailing Address - Street 2:UNIT # / 3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3063
Mailing Address - Country:US
Mailing Address - Phone:301-843-1600
Mailing Address - Fax:301-645-4734
Practice Address - Street 1:4225 ALTAMONT PL
Practice Address - Street 2:UNIT # / 3RD FLOOR
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3063
Practice Address - Country:US
Practice Address - Phone:301-843-1600
Practice Address - Fax:301-645-4734
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2010-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD30976207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE10674Medicare UPIN