Individual
MARK G BERGER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3300 ACADEMY AVE, ACADEMY CROSSING MEDICAL PLAZA, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Mailing address
3300 ACADEMY AVE, ACADEMY CROSSING MEDICAL PLAZA, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000978
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027831
ANTHEM
VA
01
—
Q80700
SENTARA
VA
Enumeration date
09/13/2005
Last updated
07/08/2007
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