MOLLIE J BERG PA-C NPI 1124352604

NPI Information

NPI: 1124352604
Provider Name: MOLLIE J BERG, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
512 S 28TH AVE
WAUSAU, WI
ZIP 54401
Phone: (715) 847-2021
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Mollie J Berg, PA-C is a medical physician assistant in Wausau, WI with 15 years of experience. Mollie J Berg, PA-C NPI is 1124352604. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

512 S 28TH AVE
WAUSAU, WI
ZIP 54401-147
Phone: (715) 847-2021
Fax: (715) 847-2325

The NPI 1124352604 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/30/2009 and was last updated on 12/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	2496023	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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