Individual
JEFFREY PAUL BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17940 FARMINGTON RD, SUITE 140, LIVONIA, MI 48152-3157
(734) 338-0600
(734) 338-0601
Mailing address
17940 FARMINGTON RD, SUITE 140, LIVONIA, MI 48152-3157
(734) 338-0600
(734) 338-0601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301041195
MI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
4301041195
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080H215880
BCBS & BCN
MI
01
—
136737
CARE CHOICES
MI
01
—
147145
GREAT LAKES HEALTH PLAN
MI
01
—
16126
M'CARE
MI
01
—
2135729
FIRST HEALTH
MI
01
—
4036582
AETNA
MI
05
—
4520279
—
MI
05
—
4561440
—
MI
01
—
665-2
TOTAL HEALTH CARE
MI
01
—
P00211584
RAILROAD MEDICARE
MI
Enumeration date
07/01/2005
Last updated
01/12/2010
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