Doctor Name: | DAWN M DETWILER BERGER |
NPI Number: | 1043210180 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 01045293 |
Business Practice Address: | 54938 State Road 13 Middlebury, IN - 465408608 |
Business Phone Number: | 5748258685 |
Business Fax Number: | 5748251256 |
Mailing Address: | 2310 California Road, ELKHART |
State: | IN |
Postal Code: | 465141228 |
Phone Number: | 5742644163 |
Fax Number: | 5742629650 |
NPI Enumeration Date: | 07/29/2005 |
NPI Last Update Date: | 02/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | 01045293 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |