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Individual
JONATHON H BERG
Active
Individual
JONATHON H BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5113
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-19160
MEDICA
—
05
—
12955
—
ND
01
—
23749
ND BCBS
ND
01
—
268M0BE
MN BCBS
MN
05
—
514800600
—
MN
01
—
917187
FIRST HEALTH (MAILHANDLERS)
—
01
—
NA9481022061
PREFERRED ONE
—
Enumeration date
07/21/2005
Last updated
07/21/2022
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