Bergstrom, Charles P.

Bergstrom, Charles P. is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Critical Care, Milwaukee WI 53226-4874. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Bergstrom, Charles P. can be contacted via phone (414) 266-3360.

Contact Information

Primary practice address
9000 W Wisconsin Ave Pediatric Critical Care Milwaukee WI 53226-4874
Phone: (414) 266-3360
Fax: (414) 266-3563
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 248026 New York
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 248026 New York
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 65736 Wisconsin

Profile Details

NPI number 1225059421
LBN Legal business name Bergstrom, Charles P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2006
Last updated Jan 29th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225059421 NPPES
California MEDICAID 00A878510
California MEDICAID 02961219
California MEDICAID 1225059421

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