MEDICARE: DR. DONALD MICHAEL BERGMAN D.C.

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
1	111N00000X	Chiropractor	1929	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1770579377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD MICHAEL BERGMAN D.C.

Provider Business Mailing Address
First Line	:	161 W SUNSET DR
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53189-7674
Country	:	US
Telephone Number	:	262-549-0606
Fax Number	:	262-549-9121

Provider Business Practice Location Address
First Line	:	161 W SUNSET DR
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53189-7674
Country	:	US
Telephone Number	:	262-549-0606
Fax Number	:	262-549-9121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	10/19/2011

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Directions to “ DR. DONALD MICHAEL BERGMAN D.C.” Practice Location

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