Individual
JONATHON H BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 SOUTH COLUMBIA ROAD, GRAND FORKS, ND 58201-4032
(701) 780-5000
(701) 587-6009
Mailing address
PO BOX 6002, GRAND FORKS, ND 58201
(701) 780-5000
(701) 587-6009
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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