Berg, Stephanie Lisa

Berg, Stephanie Lisa is an sole proprietor health care provider with primary practice located at 11 Richland Medical Park Dr , Columbia SC 29203-6863. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Berg, Stephanie Lisa can be contacted via phone (803) 434-4506.

Contact Information

Primary practice address
11 Richland Medical Park Dr Columbia SC 29203-6863
Phone: (803) 434-4506
Fax: (803) 434-1537
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 35919 Iowa
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 31221 South Carolina

Profile Details

NPI number 1508809831
LBN Legal business name Berg, Stephanie Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Nov 21st, 2022 - about 4 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 1508809831 NPPES
South Carolina MEDICAID 312218
South Carolina MEDICAID 0727552
South Carolina Other 20148

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