Provider Demographics
NPI:1750321956
Name:BERGER, MITCHELL Z (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:Z
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1200 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2529
Mailing Address - Country:US
Mailing Address - Phone:706-217-1088
Mailing Address - Fax:706-217-2040
Practice Address - Street 1:1200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:706-217-1088
Practice Address - Fax:706-217-2040
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA33028207RH0003X
MI4301110914207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology