NPI 1083143564 · live from the CMS NPI Registry
Brian William Berg, MD
Radiology, Diagnostic Radiology in Salt Lake City, UT. National Provider Identifier 1083143564, active.
NPI record
| NPI | 1083143564 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 5121 S Cottonwood St, Salt Lake City, UT 84107 |
| Practice phone | 801-507-7000 |
| Mailing address | 5217 S State St Ste 200, Murray, UT 84107 |
| Enumerated | June 8, 2017 |
| Last updated | January 30, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | MT213910 (PA) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | 13154894-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.