Basic Information
| Provider Information | |||||||||
| NPI: | 1982764502 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP | ||||||||
| Address2: | 2101 EAST JEFFERSON STREET | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018166660 | ||||||||
| FaxNumber: | 3018166308 | ||||||||
| Practice Location | |||||||||
| Address1: | 12011 LEE JACKSON MEMORIAL HWY | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220334512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033835400 | ||||||||
| FaxNumber: | 7033835547 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 163WU0100X | D22142 | MD | N | Nursing Service Providers | Registered Nurse | Urology | 163WU0100X | 0101032497 | VA | Y | Nursing Service Providers | Registered Nurse | Urology | 163WU0100X | MD31255 | DC | N | Nursing Service Providers | Registered Nurse | Urology |
No ID Information.