Individual
DR. RUSSELL DAVID BERG
Active
Individual
DR. RUSSELL DAVID BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PH.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60888448
WA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
MD60888448
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427412899
—
WA
Enumeration date
04/11/2016
Last updated
04/29/2019
Update your record
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