Individual
RUSSELL EVAN BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 DEACONESS RD, WEST CLINICAL CENTER, BOSTON, MA 02215-5321
(617) 754-2339
Mailing address
320 POPLAR ST, ROSLINDALE, MA 02131-4339
(845) 551-0260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
232101
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110087695A
—
MA
Enumeration date
08/26/2008
Last updated
02/02/2012
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