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NPI Code Detail

MEDICARE: KACI BERGMAN B.S

MEDICARE: KACI BERGMAN B.S
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
1247200000XOther Technician

General Provider Information

NPI Number : 1558299289
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACI BERGMAN B.S
Provider Business Mailing Address
First Line : 11073 WATERPOINT DR
Second Line :
City : ALLENDALE
State : MI
Zip : 49401-9666
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3769 QUARTON RD # MI
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-4058
Country : US
Telephone Number : 248-894-1966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ KACI BERGMAN B.S” Practice Location

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