Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35-028340 | OH |
NPI | 1073542817 |
---|---|
Provider Name | Dr. Thomas S Berger |
First Address | Cincinnati, OH 45264-3398 |
Second Address | Cincinnati, OH 45209-1287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 10/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0221450 | (05) | OH |
A71129 | (02) | OH |