Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DR0054273 | CO |
N | 111NI0900X | Internist | DR0054273 | CO |
NPI | 1003120502 |
---|---|
Provider Name | Erik Berger |
First Address | Broomfield, CO 80021-3408 |
Second Address | Lafayette, CO 80026-3397 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 10/09/2018 |