Bergenstal, Richard M

Bergenstal, Richard M is an individual health care provider with primary practice located at 3800 Park Nicollet Blvd , St Louis Park MN 55416-2527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Bergenstal, Richard M can be contacted via phone (952) 993-3393.

Contact Information

Primary practice address
3800 Park Nicollet Blvd St Louis Park MN 55416-2527
Phone: (952) 993-3393
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 28104 Minnesota

Profile Details

NPI number 1669459061
LBN Legal business name Bergenstal, Richard M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Oct 20th, 2011 - about 13 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 1669459061 NPPES
Minnesota MEDICAID 416067300

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