| Tod L Berg, M.D., P.C. | |
|
1467 S Highway 40 Heber City UT 84032-3522 | |
| (435) 654-6321 | |
| (435) 654-6364 |
| Full Name | Tod L Berg, M.D., P.C. |
|---|---|
| Speciality | Family Medicine |
| Location | 1467 S Highway 40, Heber City, Utah |
| Authorized Official Name and Position | Tod L Berg (OWNER) |
| Authorized Official Contact | 4356546321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tod L Berg, M.D., P.C. 1467 S Highway 40 Heber City UT 84032-3522 Ph: (435) 654-6321 | Tod L Berg, M.D., P.C. 1467 S Highway 40 Heber City UT 84032-3522 Ph: (435) 654-6321 |
| NPI Number | 1245496355 |
|---|---|
| Provider Enumeration Date | 07/29/2008 |
| Last Update Date | 07/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245496355 | NPI | - | NPPES |
| 1245496355 | Other | UT | ORGANIZATIONAL NPI |
| 529061882001 | Medicaid | UT | |
| 1497713648 | Other | UT | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2644771205 (Utah) | Primary |
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