Bergan, James R

Bergan, James R is an individual health care provider with primary practice located at 15800 95Th Ave N , Maple Grove MN 55369-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bergan, James R can be contacted via phone (952) 993-1440.

Contact Information

Primary practice address
15800 95Th Ave N Maple Grove MN 55369-4400
Phone: (952) 993-1440
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22332 Minnesota

Profile Details

NPI number 1669459020
LBN Legal business name Bergan, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Feb 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1669459020 NPPES
Minnesota MEDICAID 929788000

Popular Providers