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NPI Code Detail

MEDICARE: DR. BERTA M BERGIA MD

MEDICARE:  DR. BERTA M BERGIA  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
12084N0600XClinical Neurophysiology Physician17849TN
2282N00000XGeneral Acute Care Hospital17849TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23026559OTHERTN3026559

General Provider Information

NPI Number : 1275501728
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERTA M BERGIA MD
Provider Business Mailing Address
First Line : DEPT 888217
Second Line :
City : KNOXVILLE
State : TN
Zip : 37995-8217
Country : US
Telephone Number : 865-670-6199
Fax Number : 865-670-6198
Provider Business Practice Location Address
First Line : 9352 PARK WEST BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4325
Country : US
Telephone Number : 865-373-1974
Fax Number : 865-373-1059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 04/01/2013

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Directions to “ DR. BERTA M BERGIA MD” Practice Location

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