Provider Demographics
NPI:1154335511
Name:BERG, RALPH ROGER JR (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ROGER
Last Name:BERG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1503 WAYNE MEMORIAL DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2203
Mailing Address - Country:US
Mailing Address - Phone:919-330-4367
Mailing Address - Fax:919-330-4375
Practice Address - Street 1:1503 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE H
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2203
Practice Address - Country:US
Practice Address - Phone:919-330-4367
Practice Address - Fax:919-330-4375
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-05-21
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Provider Licenses
StateLicense IDTaxonomies
NC336132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB35593Medicare UPIN