Mary Ellen Berg in Shreveport - Ophthalmology
Mary Ellen Berg - NPI 1174524391
Mary Ellen Berg is a Ophthalmology in Shreveport, Louisiana. Mary Ellen Berg practices all healthcare services and medical treatments related to Ophthalmology. The NPI Number for Mary Ellen Berg is 1174524391. The last update date is 2020-12-11.
Mary Ellen Berg's current location address is 471 Ashley Ridge Blvd, Shreveport, Louisiana. You can contact this provider via phone number 3187954770 and fax number 3187954775. The mailing address for Mary Ellen Berg is 471 Ashley Ridge Blvd, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Ellen Berg |
|---|---|
| Address | 471 Ashley Ridge Blvd, Shreveport, Louisiana |
| Phone Number | 3187954770 |
| Fax Number | 3187954775 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1174524391 |
|---|---|
| Provider Enumeration Date | 2005-08-10 |
| Last Updated Date | 2020-12-11 |
Provider Mailing Address Detail
| Address | 471 Ashley Ridge Blvd |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 71106 |
| Phone Number | 3187954770 |
| Fax Number | 3187954775 |
Provider's Primary Taxonomy Detail
| Speciality | Ophthalmology |
|---|---|
| Taxonomy | 207W00000X |
| Licence No | 19001 |
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Definition: An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This incl |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 123802001 | AR | ARKANSAS MEDICAID | |
| 1053315846 | LA | GROUP MEDICARE NUMBER | |
| 1922871 | LA | -- | |
| 78737601 | TX | TEXAS MEDICAID | |
| P00375906 | LA | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mary Ellen Berg by the Centers for Medicare & Medicaid Services?
The Mary Ellen Berg has been issued the NPI (National Provider Identifier) 1174524391, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Mary Ellen Berg located?
The Mary Ellen Berg is located at 471 Ashley Ridge Blvd, Shreveport, LA 71106.
What is Mary Ellen Berg's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Ellen Berg's area of specialization is Ophthalmology, and the corresponding taxonomy code that categorizes this field of practice is 207W00000X.
On what date was the 1174524391 assigned to Mary Ellen Berg?
The Mary Ellen Berg was issued its 1174524391 on 2005-08-10, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Mary Ellen Berg, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mary Ellen Berg, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-12-11.