Individual
MICHAEL S BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 622-8170
(505) 624-8711
Mailing address
209 TIERRA BERRENDA DR, ROSWELL, NM 88201-7869
(435) 789-3952
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4961614-4406
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
R59727
NM
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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