| Michael D Bergman Md Llc | |
|
61 Woodstock Rd Hamden CT 06517-2949 | |
| (203) 671-1149 | |
| (774) 209-4751 |
| Full Name | Michael D Bergman Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 61 Woodstock Rd, Hamden, Connecticut |
| Authorized Official Name and Position | Michael D Bergman (OWNER) |
| Authorized Official Contact | 2036711149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D Bergman Md Llc 61 Woodstock Rd Hamden CT 06517-2949 Ph: (203) 671-1149 | Michael D Bergman Md Llc 61 Woodstock Rd Hamden CT 06517-2949 Ph: (203) 671-1149 |
| NPI Number | 1639526890 |
|---|---|
| Provider Enumeration Date | 05/18/2016 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 0749574291 |
|---|---|
| Medicare Enrollment ID | O20160808000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639526890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Michael D Bergman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780694331 PECOS PAC ID: 4385544592 Enrollment ID: I20040113000376 |
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