Individual
DR. RICHARD A. BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22201 MOROSS RD, SUITE 155, DETROIT, MI 48236-2169
(586) 247-4300
Mailing address
45640 SCHOENHERR RD, SUITE B, SHELBY TOWNSHIP, MI 48315-6033
(586) 247-4300
(586) 532-6496
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301041478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020H21281
BCBSM
—
05
—
1846920
—
MI
Enumeration date
09/28/2005
Last updated
02/08/2016
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