Fanny J Berg, MD
Individual provider Active NPI Specialist · Wilmington, DE
NPI 1720182256 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1720182256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- C1-0002879 (DE)
- Practice address
- 2000 Foulk Rd
Suite a
Wilmington, DE 19810-3642 - Phone
- (302) 475-8000
- Fax
- (302) 475-8043
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania Dermatology Partners Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | C1-0002879 | DE | Yes |
Addresses
Primary practice location
2000 Foulk Rd
Suite a
Wilmington, DE 19810-3642
Mailing address
2000 Foulk Rd
Suite a
Wilmington, DE 19810-3642
Phone (302) 475-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000035901 | Medicaid | DE |
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2015. 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.