Organization Name: | DONALD D BERG MD PC |
NPI Number: | 1053492785 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD D BERG (PRESIDENT) |
Mailing Address: | 1005 Pennsylvania Ave Suite 212 Ottumwa |
State: | IA US |
Postal Code: | 525016413 |
Phone Number: | 6416825443 |
Fax Number: | 6416826859 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 09/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 18416 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |