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Ira Lawrence Berger

Internal Medicine

Allopathic & Osteopathic Physicians

1201 Seven Locks Rd, Ste 111, Rockville, MD 20854-2957

PECOS Enrollment

This provider is enrolled in PECOS as IRA BERGER.

Based on the most recent information from CMS, provider Ira Lawrence Berger is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1013913284
Provider Type
Individual
Full Name
Berger, Ira Lawrence
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/22/2005
Last Updated
10/10/2016

Contact Information

Practice Location

1201 Seven Locks Rd, Ste 111, Rockville, MD 20854-2957

(301) 762-5020

(301) 294-7569

Mailing Location

PO Box 79632, Baltimore, MD 21279-0632

(301) 762-5020

(301) 309-3783

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License D0044157 Maryland
Code 207RP1001X	Description Internal Medicine Allopathic & Osteopathic Physicians	License D0044157 Maryland

Provider Identifiers

ID	Description	Issuer
ID 415096100	Description Medicaid	Issuer Unlisted Maryland

Ira Lawrence Berger

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Zheng, Yanfang

Houn, Florence

Kassis, Leonard Khalil

Fredd, Stephen

Samtani, Rajeev

Samarasinghe, Pasindu Bharatha

Li, Ping

M Medical Group, Inc.

Flynn, Robert Lawrence

Kshama Garg