Michael Berg, PHARM D
Individual provider Active NPI Pharmacist · Laveen, AZ
NPI 1033440417 · NPPES record last updated Jan 25, 2010
Key facts
- NPI
- 1033440417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S014163 (AZ)
- Practice address
- 5115 W Baseline Rd
Laveen, AZ 85339-3000 - Phone
- (602) 283-1603
- Fax
- (602) 283-1607
- NPI assigned
- Jan 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S014163 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S014163 | AZ | Yes |
Addresses
Primary practice location
5115 W Baseline Rd
Laveen, AZ 85339-3000
Mailing address
5115 W Baseline Rd
Laveen, AZ 85339-3000
Phone (602) 283-1603
Other providers in Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.