Individual
ZACHARY BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N 1900 E RM 1A071, SALT LAKE CITY, UT 84132-0002
(801) 581-2121
Mailing address
PO BOX 1108, CORVALLIS, OR 97339-1108
(805) 286-3826
(805) 221-6843
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
9529133-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
M-15077
ID
Other
Enumeration date
07/23/2014
Last updated
06/04/2020
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