Healthcare Provider Details

I. General information

NPI: 1366517153
Provider Name (Legal Business Name): BIRGER STEVEN BENTSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 MEETING CT
WILMINGTON NC
28401-6631
US

IV. Provider business mailing address

10741 TREGO TRL
RALEIGH NC
27614-9660
US

V. Phone/Fax

Practice location:
  • Phone: 910-815-0260
  • Fax: 910-763-3311
Mailing address:
  • Phone: 910-524-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number28461
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number28461
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: