Individual
JAKE E BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 MATTHEW ST, OUTREACH/FERGUSON BUILDING, MARIETTA, OH 45750-4575
(740) 568-5669
Mailing address
401 MATTHEW ST, OUTREACH/FERGUSON BUILDING, MARIETTA, OH 45750
(740) 568-5669
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.016875
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2021
Last updated
03/31/2024
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