Bergeron, Glynn A
Bergeron, Glynn A is an individual health care provider with primary practice located at 6 Wheeler Ct , Savannah GA 31405-5719. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bergeron, Glynn A can be contacted via phone (912) 355-8200.Contact Information
Primary practice address
6 Wheeler Ct
Savannah GA 31405-5719
Phone: (912) 355-8200
Fax: (912) 356-6967
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 19482 | Georgia |
Profile Details
| NPI number | 1578566352 |
|---|---|
| LBN Legal business name | Bergeron, Glynn A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1578566352 | NPPES |
| Georgia | MEDICAID | 00153029A | |
| Georgia | Other | 003681 |
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