Provider Demographics
NPI:1700849676
Name:BERGER, JAMES IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:IRWIN
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1802 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4649
Mailing Address - Country:US
Mailing Address - Phone:801-479-9663
Mailing Address - Fax:801-475-4101
Practice Address - Street 1:5475 S 500 E
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6905
Practice Address - Country:US
Practice Address - Phone:801-476-4280
Practice Address - Fax:801-476-4281
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT188737-12052080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine