Healthcare Provider Details

I. General information

NPI: 1639164957
Provider Name (Legal Business Name): PATTY SUE OHRUM-BERGMUELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST INPATIENT SERVICES
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

100 E CARROLL ST ATTN: PRMG
SALISBURY MD
21801-5422
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-7536
  • Fax: 410-543-7272
Mailing address:
  • Phone: 410-543-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD423834
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD423834
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: