Eugene Elliot Berg, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

9793 Issued in NH

Practice address

4 Hawthorne Dr
Bedford, NH 03110-6912

Phone

(603) 472-8888

Fax

(603) 472-9090

NPI assigned

Aug 30, 2005

Last updated

Sep 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1073506523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 CHARLES BANCROFT HWY",
            "city": "LITCHFIELD",
            "state": "NH",
            "postal_code": "030522309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HAWTHORNE DR",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106912",
            "telephone_number": "603-472-8888",
            "fax_number": "603-472-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "EUGENE",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NH",
            "license": "9793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010506",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benchmark Arbors of Bedford LLC (Arbors of Bedford)
• Jessica Bennett, LCMHC, LADC
• Lydia B. Bennett, MD
• Bentley Senior Living, LLC
• Jennifer Lee Berard, PTA
• Christina Berge, FNP-BC
• Lisa Berge, FNP-BC, PHD
• Lindsay Marie Bergeron, MD
• Noel Berrio, BCBA
• Shanni Geller Berry

• Sports Medicine (Orthopaedic Surgery) Physician in Bedford, NH
• Providers in Bedford, NH by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.