Bergom, Carmen Renee
Bergom, Carmen Renee is an individual health care provider with primary practice located at 1255 Graham Rd Dept Radiation Oncology, Florissant MO 63031-8014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Bergom, Carmen Renee can be contacted via phone (314) 820-6751.Contact Information
Primary practice address
1255 Graham Rd Dept Radiation Oncology
Florissant MO 63031-8014
Phone: (314) 820-6751
Fax: (314) 820-6752
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 2020031317 | Missouri |
Profile Details
| NPI number | 1932363553 |
|---|---|
| LBN Legal business name | Bergom, Carmen Renee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2008 |
| Last updated | Apr 25th, 2024 - about 2 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 | 1932363553 | NPPES |
| Missouri | MEDICAID | 200089105 |
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