Individual
DR. KENNETH WILLIAM BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6305 CASTLE PL, SUITE 2D, FALLS CHURCH, VA 22044-1905
(703) 534-5500
(703) 534-4838
Mailing address
PO BOX 1987, SKYLAND, NC 28776-1987
(828) 575-2644
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101011603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376582A01
MEDICARE PTAN
VA
Enumeration date
08/29/2006
Last updated
11/16/2015
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