Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 32360 | MA |
N | 207VG0400X | Gynecologist | 32360 | MA |
NPI | 1215974506 |
---|---|
Provider Name | Dr. Merle Jay Berger |
First Address | Waltham, MA 02451-1100 |
Second Address | Waltham, MA 02451-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 01/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3027261 | (05) | MA |
B99177 | (02) | MA |