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NPI Code Detail

MEDICARE: DR. STEPHEN BERGMAN D.O.

MEDICARE: DR. STEPHEN BERGMAN D.O.
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 PhysicianDO21112OR

General Provider Information

NPI Number : 1669475562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN BERGMAN D.O.
Provider Business Mailing Address
First Line : 741 NE 6TH ST
Second Line :
City : GRANTS PASS
State : OR
Zip : 97526-1556
Country : US
Telephone Number : 541-471-2701
Fax Number : 541-471-1166
Provider Business Practice Location Address
First Line : 741 NE 6TH ST
Second Line :
City : GRANTS PASS
State : OR
Zip : 97526-1556
Country : US
Telephone Number : 541-471-2701
Fax Number : 541-471-1166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/11/2007

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Directions to “ DR. STEPHEN BERGMAN D.O.” Practice Location

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