Individual
GRANT S BERGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7881
(928) 537-6338
Mailing address
PO BOX 548, COTTONWOOD, AZ 86326-0548
(928) 634-0665
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36654
AZ
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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