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General NPI Number Information
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NPI Number | 1275501728
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Entity Type | Individual
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Provider Name | BERTA M BERGIA MD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 9352 PARK WEST BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37923-4325
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Country | US
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Telephone | 865-373-1974
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Fax | 865-373-1059
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Provider Business Mailing Address
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Address Line | DEPT 888217
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City | KNOXVILLE
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State | TN
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Zip | 37995-8217
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 17849
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 17849
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License Number State | TN
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