Provider Demographics
NPI:1679884993
Name:BERGER, MATTHEW S (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:BERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:406-A BLACK HILLS LN SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502
Mailing Address - Country:US
Mailing Address - Phone:360-754-1737
Mailing Address - Fax:360-704-3408
Practice Address - Street 1:406-A BLACK HILLS LN SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-754-1737
Practice Address - Fax:360-704-3408
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60639255207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease