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1164685749

NPI Code Detail

MEDICARE: DR. KRISTINA WONG BERMAS MD

MEDICARE: DR. KRISTINA WONG BERMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	52918	AZ
2	208600000X	Surgery Physician	MD29501	ME
3	2086S0102X	Surgical Critical Care Physician	52918	AZ
4	2086S0102X	Surgical Critical Care Physician	24064	NH
5	2086S0127X	Trauma Surgery Physician	52918	AZ
6	2086S0102X	Surgical Critical Care Physician	MD29501	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z199291	OTHER	AZ	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164685749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINA WONG BERMAS MD

Provider Business Mailing Address
First Line	:	887 CONGRESS ST STE 400
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-3163
Country	:	US
Telephone Number	:	207-774-6368
Fax Number	:	207-774-9388

Provider Business Practice Location Address
First Line	:	887 CONGRESS ST STE 400
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-3163
Country	:	US
Telephone Number	:	207-774-6368
Fax Number	:	207-774-9388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	08/14/2025

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Directions to “ DR. KRISTINA WONG BERMAS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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