Provider Demographics
NPI:1922038900
Name:BERGS, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BERGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3805B SPRING ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-1641
Mailing Address - Country:US
Mailing Address - Phone:262-687-8108
Mailing Address - Fax:262-687-8109
Practice Address - Street 1:3805B SPRING ST
Practice Address - Street 2:SUITE 240
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-1641
Practice Address - Country:US
Practice Address - Phone:262-687-8108
Practice Address - Fax:262-687-8109
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI301862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIE88933Medicare UPIN