Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | D0044157 | MD |
Y | 111NI0900X | Internist | D0044157 | MD |
N | 207RP1001X | Pulmonary Disease | D0044157 | MD |
NPI | 1013913284 |
---|---|
Provider Name | Dr. Ira Lawrence Berger |
First Address | Baltimore, MD 21279-0632 |
Second Address | Rockville, MD 20854-2957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 10/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
415096100 | (05) | MD |
F50141 | (02) | MD |