Individual
EDWARD D BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7201 W SAGINAW HWY, SUITE 300, LANSING, MI 48917-1131
(517) 321-6801
Mailing address
7201 W SAGINAW HWY, SUITE 300, LANSING, MI 48917-1131
(517) 321-6801
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
EB006059
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0452329554
BLUE CROSS BLUE SHIELD
MI
05
—
1063159
—
MI
01
—
200000002582
PHPMM
MI
Enumeration date
06/14/2006
Last updated
10/15/2007
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