| Michael E. Berger Pa | |
|
5353 Gamble Dr Suite 160 St Louis Park MN 55416-1509 | |
| (952) 929-2276 | |
| (952) 929-8576 |
| Full Name | Michael E. Berger Pa |
|---|---|
| Speciality | Psychologist |
| Location | 5353 Gamble Dr, St Louis Park, Minnesota |
| Authorized Official Name and Position | Michael Berger (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9529292276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E. Berger Pa 5353 Gamble Dr Suite 160 St Louis Park MN 55416-1509 Ph: (952) 929-2276 | Michael E. Berger Pa 5353 Gamble Dr Suite 160 St Louis Park MN 55416-1509 Ph: (952) 929-2276 |
| NPI Number | 1841347085 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 06/26/2014 |
| Medicare PECOS PAC ID | 0547303554 |
|---|---|
| Medicare Enrollment ID | O20100129000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841347085 | NPI | - | NPPES |
| 431547200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP 1910 (Minnesota) | Primary |
| Provider Name | Michael E Berger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831180579 PECOS PAC ID: 6002959012 Enrollment ID: I20100129000394 |
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