| Doctor Name: | DR. MARK A BERG |
| NPI Number: | 1245221647 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 38780 |
| Business Practice Address: | 1400 1st St Ne New Prague, MN - 560712215 |
| Business Phone Number: | 9527582535 |
| Business Fax Number: | 9525486160 |
| Mailing Address: | 511 Lady Slipper Ave Ne, NEW PRAGUE |
| State: | MN |
| Postal Code: | 560712193 |
| Phone Number: | 9527588000 |
| Fax Number: | 9525486160 |
| NPI Enumeration Date: | 11/03/2005 |
| NPI Last Update Date: | 07/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | 38780 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |