Provider Demographics
NPI:1780646588
Name:BERGE, JOHN LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LOUIS
Last Name:BERGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7250 FRANCE AVE S STE 410
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4314
Mailing Address - Country:US
Mailing Address - Phone:952-831-1551
Mailing Address - Fax:952-831-0725
Practice Address - Street 1:7600 FRANCE AVE S STE 4100
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-831-1551
Practice Address - Fax:952-831-0725
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2018-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN43858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN171812OtherUCARE MN
MN074K1BEOtherBCBS OF MN
MN1029532OtherPREFERRED ONE
MN6605857OtherMEDICA UC
MN792653700Medicaid
MNHP38696OtherHEALTHPARTNERS
MN1652397OtherAMERICA'S PPO
MN0113514OtherMEDICA
MN0113514OtherMEDICA
MN074K1BEOtherBCBS OF MN
MN6605857OtherMEDICA UC