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Individual

DR. KENT BRADLEY BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 S. 11TH STREET, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S. 11TH STREET, SUITE 8490, PHILADELPHIA, PA 32891-4824
(215) 955-6161
(215) 923-5507

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD458608
PA
207L00000X
Anesthesiology Physician
ME100934
FL
207L00000X
Anesthesiology Physician
TRN7704
FL

Other

Enumeration date
11/17/2006
Last updated
09/08/2016
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