| Paul A Bergfelder Md Llc | |
|
1915 Chester Blvd Richmond IN 47374-1281 | |
| (765) 935-2567 | |
| (765) 962-0880 |
| Full Name | Paul A Bergfelder Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1915 Chester Blvd, Richmond, Indiana |
| Authorized Official Name and Position | Paul Allen Bergfelder (OWNER) |
| Authorized Official Contact | 7659352567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul A Bergfelder Md Llc 1915 Chester Blvd Richmond IN 47374-1281 Ph: (765) 935-2567 | Paul A Bergfelder Md Llc 1915 Chester Blvd Richmond IN 47374-1281 Ph: (765) 935-2567 |
| NPI Number | 1518136993 |
|---|---|
| Provider Enumeration Date | 02/29/2008 |
| Last Update Date | 11/07/2012 |
| Medicare PECOS PAC ID | 1658547237 |
|---|---|
| Medicare Enrollment ID | O20120103000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518136993 | NPI | - | NPPES |
| 201063810A | Medicaid | IN | |
| 0062146 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul A Bergfelder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508872938 PECOS PAC ID: 2567638141 Enrollment ID: I20120103000418 |
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