Individual
ELIJAH BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
585 LEBANON ST, MELROSE, MA 02176-3225
(781) 979-3000
Mailing address
8 PARK AVE, NEWTON, MA 02458-2608
(781) 280-1520
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
153206
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3175677
—
MA
01
—
J17949
BCBS
MA
Enumeration date
03/17/2006
Last updated
02/21/2014
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