Basic Information
| Provider Information | |||||||||
| NPI: | 1417952987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERGES | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 READS WAY | ||||||||
| Address2: | SUITE# 201 | ||||||||
| City: | NEW CASTLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197201630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027094510 | ||||||||
| FaxNumber: | 3023569304 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 MIDDLEFORD RD | ||||||||
| Address2: | NANTICOKE HOSPITAL | ||||||||
| City: | SEAFORD | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026296611 | ||||||||
| FaxNumber: | 3026286359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 05/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD040148E | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1106503 | 05 | NJ | MEDICAID |