Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | D0030848 | MD |
NPI | 1013068592 |
---|---|
Provider Name | Dr. Zidi Berger |
First Address | Bethesda, MD 20817-1191 |
Second Address | Bethesda, MD 20817-1191 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2007 |
Last Update Date | 08/07/2007 |