Bergh, Kent Davis
Bergh, Kent Davis is an individual health care provider with primary practice located at 3100 Kennard St Suite 100 Healtheast Physician Service,, Maplewood MN 55109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bergh, Kent Davis can be contacted via phone (651) 232-7800.Contact Information
Primary practice address
3100 Kennard St Suite 100 Healtheast Physician Service,
Maplewood MN 55109
Phone: (651) 232-7800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21143 | Minnesota |
Profile Details
| NPI number | 1467497610 |
|---|---|
| LBN Legal business name | Bergh, Kent Davis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2006 |
| Last updated | Jun 8th, 2010 - about 16 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 | 1467497610 | NPPES |
| Minnesota | Other | HP20018 | HEALTHPARTNERS |
| Minnesota | Other | 01-22438 | HEALTHPARTNERS |
| Minnesota | MEDICAID | 1540237 | HEALTHPARTNERS |
| Minnesota | Other | 66-07567 | HEALTHPARTNERS |
| Minnesota | Other | 102680 | HEALTHPARTNERS |
| Minnesota | Other | 97384BE | HEALTHPARTNERS |
| Minnesota | MEDICAID | 341595300 | HEALTHPARTNERS |
| Minnesota | Other | 1000069 | HEALTHPARTNERS |
| Minnesota | Other | 768021 | HEALTHPARTNERS |
| Minnesota | Other | 411743943 | HEALTHPARTNERS |
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