Individual
JACK M BERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5829 WOODLANE BAY, WOODBURY, MN 55129
(651) 491-9303
Mailing address
2025 WOODLANE DR, WOODBURY, MN 55125-2987
(651) 491-9303
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
21554
MN
Other
Enumeration date
03/20/2006
Last updated
12/05/2018
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