Provider Demographics
NPI:1013068592
Name:BERGER, ZIDI (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIDI
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 FERNWOOD RD STE 402
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1191
Mailing Address - Country:US
Mailing Address - Phone:301-493-7880
Mailing Address - Fax:301-493-9851
Practice Address - Street 1:10215 FERNWOOD RD STE 402
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1191
Practice Address - Country:US
Practice Address - Phone:301-493-7880
Practice Address - Fax:301-493-9851
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0030848208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice