Individual
GARY RYAN BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD29442
OR
390200000X
Student in an Organized Health Care Education/Training Program
TL-2216
CO
Other
Enumeration date
01/30/2007
Last updated
07/07/2009
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