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Individual

EVAN R BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 414-5481
(617) 414-7759
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
215357
MA
207P00000X
Emergency Medicine Physician
232041
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110007139A
MA
05
3120664
NH
Enumeration date
10/07/2005
Last updated
05/31/2023
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