Individual
DR. RONALD MARK BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5012 DORSEY HALL DR, SUITE 105, ELLICOTT CITY, MD 21042-7711
(410) 730-8878
(410) 997-8272
Mailing address
5012 DORSEY HALL DR, SUITE 105, ELLICOTT CITY, MD 21042-7711
(410) 730-8878
(410) 997-8272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA0679
MD
152WC0802X
Corneal and Contact Management Optometrist
TA0679
MD
152WP0200X
Pediatric Optometrist
TA0679
MD
152WS0006X
Sports Vision Optometrist
TA0679
MD
152WV0400X
Vision Therapy Optometrist
TA0679
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269818800
—
MD
Enumeration date
06/23/2006
Last updated
03/09/2010
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