Provider Demographics
NPI:1588933220
Name:BERGER, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-1050
Mailing Address - Country:US
Mailing Address - Phone:218-998-2778
Mailing Address - Fax:218-998-2238
Practice Address - Street 1:1888 COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1050
Practice Address - Country:US
Practice Address - Phone:218-998-2778
Practice Address - Fax:218-998-2238
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications