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Individual

LESLY BERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9011 CHEVROLET DR, SUITES 1-6, ELLICOTT CITY, MD 21042-4024
(410) 465-7550
(410) 465-7085
Mailing address
9011 CHEVROLET DR, SUITES 1-6, ELLICOTT CITY, MD 21042-4024
(410) 465-7550
(410) 465-7085

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0054406
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
492600500
MD
Enumeration date
04/13/2006
Last updated
09/18/2012
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