Organization
TOD L BERG, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOD L BERG M.D. (OWNER)
(435) 654-6321
Entity
Organization
Contact information
Practice address
1467 S HIGHWAY 40, HEBER CITY, UT 84032-3522
(435) 654-6321
(435) 654-6364
Mailing address
1467 S HIGHWAY 40, HEBER CITY, UT 84032-3522
(435) 654-6321
(435) 654-6364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2644771205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245496355
ORGANIZATIONAL NPI
UT
01
—
1497713648
INDIVIDUAL NPI
UT
05
—
529061882001
—
UT
Enumeration date
07/29/2008
Last updated
07/30/2008
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