Samuel William Berg II, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101054512 Issued in VA

Practice address

3130 Victoria Blvd
Hampton, VA 23661-1544

Phone

(757) 315-3763

Fax

(757) 727-1185

NPI assigned

Mar 10, 2006

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1659349017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 VICTORIA BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236611544",
            "telephone_number": "757-315-3763",
            "fax_number": "757-727-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 VICTORIA BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236611544",
            "telephone_number": "757-315-3763",
            "fax_number": "757-727-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SAMUEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101054512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975014",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "089265",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA HEALTH",
            "identifier": "47211",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "4975014",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Bennett
• Brian Benson-Lee, RBT
• Kaelyn Benton-Hooker, PHARMD
• Janelle Benzick, RDN
• Arnold Sherman Beresh, DPM
• Kabaye Berhanu, MD
• Jerry Lloyd Berman, D.O.
• Michael Berndt
• Bernices Granddaughter Inc
• Driss Berrada, MD

• Internal Medicine Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.