Healthcare Provider Details

I. General information

NPI: 1770296659
Provider Name (Legal Business Name): PORTSMOUTH TRAUMA AND SURGICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BORTHWICK AVE STE 308
PORTSMOUTH NH
03801-7112
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 615-372-5426
  • Fax:
Mailing address:
  • Phone: 615-373-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE BERGAMO
Title or Position: VICE PRESIDENT
Credential:
Phone: 804-267-5950