Mark L Berger, MD
Individual provider Active NPI Neurology Physician · Albuquerque, NM
NPI 1124034830 · NPPES record last updated Jul 26, 2010
Key facts
- NPI
- 1124034830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 829 (NM)
- Practice address
- 4273 Montgomery Blvd NE
Suite 110
Albuquerque, NM 87109-6746 - Phone
- (505) 944-7555
- Fax
- (505) 944-7552
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 829 | NM | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 829 | NM | Yes |
Addresses
Primary practice location
4273 Montgomery Blvd NE
Suite 110
Albuquerque, NM 87109-6746
Mailing address
4273 Montgomery Blvd NE
Suite 110
Albuquerque, NM 87109
Phone (505) 944-7555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23085 | Medicaid | NM |
Other providers in Albuquerque, NM
- Thomas Olaf Berge
- Audrey R Bergen
- Sean Bergen
- Howard Stephen Berger
- Joel Charles Berger
- Mary Berger
- Michelle Berger
- Deborah Bergeron
- Tricia Monique Bergeron
- Sara Bergert
All providers in Albuquerque, NM · Neurology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 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.