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NPI Code Detail

MEDICARE: ANGELA BERGMANN M.D.

MEDICARE: ANGELA BERGMANN M.D.
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
1207Q00000XFamily Medicine Physician47173MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NA9021045918OTHERMNPREFERRED ONE
212-03451OTHERMNMEDICA
3HP57679OTHERMNHEALTH PARTNERS
4182090OTHERMNUCARE

General Provider Information

NPI Number : 1518926773
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA BERGMANN M.D.
Provider Business Mailing Address
First Line : 1311 KENILWORTH DR
Second Line :
City : WOODBURY
State : MN
Zip : 55125-2354
Country : US
Telephone Number : 651-493-2642
Fax Number :
Provider Business Practice Location Address
First Line : 153 CESAR CHAVEZ ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2226
Country : US
Telephone Number : 651-222-1816
Fax Number : 651-602-7517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/08/2007

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Directions to “ ANGELA BERGMANN M.D.” Practice Location

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