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Individual

JONATHAN A BERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5001 US HIGHWAY 30 W STE D, FORT WAYNE, IN 46818-9701
(260) 432-1568
(260) 432-4969
Mailing address
PO BOXS 80070, FORT WAYNE, IN 46898
(260) 432-1568
(260) 432-4969

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01037032A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0738358
OH
05
100328240A
IN
05
1093790255
MI
Enumeration date
12/09/2005
Last updated
10/02/2025
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