Provider Demographics
NPI:1871711374
Name:BERG, DEAN (OPA)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:BERG
Suffix:
Gender:M
Credentials:OPA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3385 DEXTER CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3471
Mailing Address - Country:US
Mailing Address - Phone:563-344-9292
Mailing Address - Fax:563-344-9573
Practice Address - Street 1:3385 DEXTER CT
Practice Address - Street 2:SUITE 300
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3471
Practice Address - Country:US
Practice Address - Phone:563-344-9292
Practice Address - Fax:563-344-9573
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant