Provider Demographics
NPI:1881654507
Name:BERGER, ALLAN SIDNEY (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:SIDNEY
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 MIDWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1645
Mailing Address - Country:US
Mailing Address - Phone:301-589-1443
Mailing Address - Fax:301-608-8001
Practice Address - Street 1:1302 MIDWOOD PL
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1645
Practice Address - Country:US
Practice Address - Phone:301-589-1443
Practice Address - Fax:301-608-8001
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00005592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC179596Medicare PIN