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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669459020 | NPPES |
| Minnesota | MEDICAID | 929788000 |
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