Individual
MARY E. BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
980 JOHNSON FERRY RD STE 520, ATLANTA, GA 30342-1637
(404) 303-3320
(404) 303-3464
Mailing address
755 WALTHER RD, LAWRENCEVILLE, GA 30045-8725
(770) 252-0399
(770) 822-5389
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
41726
GA
207UN0901X
Nuclear Cardiology Physician
41726
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00685176A
—
GA
Enumeration date
09/21/2005
Last updated
10/12/2020
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