Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | OP00001080 | WA |
NPI | 1013913029 |
---|---|
Provider Name | Dr. Philip William Berger |
First Address | Olympia, WA 98502-8144 |
Second Address | Olympia, WA 98502-8144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 04/11/2009 |