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Individual

KENNETH C BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
525 W RIVER WOODS PKWY STE 100, GLENDALE, WI 53212-1010
(414) 332-6262
(414) 332-0422
Mailing address
525 W RIVER WOODS PKWY STE 100, GLENDALE, WI 53212-1010
(414) 332-6262
(414) 332-0422

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
64556
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578981213
WI
Enumeration date
03/31/2014
Last updated
10/07/2024
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