Organization
BERG MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANELLE SCHUBLOOM (OFFICE MANAGER)
(605) 854-9100
Entity
Organization
Contact information
Practice address
221 CALUMET AVE SW, DE SMET, SD 57231
(605) 854-9100
(605) 854-9238
Mailing address
221 CALUMET AVE SW, DE SMET, SD 57231
(605) 854-9100
(605) 854-9238
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
SD 4247
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4996058
SD BLUE SHIELD
SD
05
—
5602487
—
SD
Enumeration date
12/27/2007
Last updated
01/03/2008
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