Individual
JACOB TYRELL BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
205 SMALLBERRY CT, SNEADS FERRY, NC 28460-6827
(307) 630-9380
Mailing address
7711 S SUNNYCREST RD, SEATTLE, WA 98178-2749
(307) 630-9380
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS20890
FL
Other
Enumeration date
05/06/2019
Last updated
09/30/2024
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