Berg, Evan R

Berg, Evan R is an individual health care provider with primary practice located at 1 Boston Medical Ctr Pl , Boston MA 02118-2908. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Berg, Evan R can be contacted via phone (617) 414-5481.

Contact Information

Primary practice address
1 Boston Medical Ctr Pl Boston MA 02118-2908
Phone: (617) 414-5481
Fax: (617) 414-7759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 232041 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 215357 Massachusetts

Profile Details

NPI number 1982692596
LBN Legal business name Berg, Evan R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated May 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982692596 NPPES
New Hampshire MEDICAID 3120664
New Hampshire MEDICAID 110007139A

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