Provider Demographics
NPI:1184612814
Name:BERG, CHIQUITA LASHANE (MD)
Entity type:Individual
Prefix:MS
First Name:CHIQUITA
Middle Name:LASHANE
Last Name:BERG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:CHIQUITA
Other - Middle Name:LASHANE
Other - Last Name:HINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR STE J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:32932 WARREN RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3095
Practice Address - Country:US
Practice Address - Phone:734-743-4500
Practice Address - Fax:734-743-4362
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134169207V00000X
IN01079219A207V00000X
MI4301077885207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology