Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 25MA11321600 | NJ |
Y | 207P00000X | Emergency Physician | MD473803 | PA |
N | 207PE0004X | Emergency Medical Services | MT215257 | PA |
NPI | 1164915682 |
---|---|
Provider Name | Dr. Matthew Berger |
First Address | Pennington, NJ 08534-2520 |
Second Address | Philadelphia, PA 19140-5103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2018 |
Last Update Date | 10/01/2022 |