Bergevin, Michael A.
Bergevin, Michael A. is an individual health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Pediatric Pathology is his primary health care specialty. Bergevin, Michael A. can be contacted via phone (757) 668-7007.Contact Information
Primary practice address
601 Childrens Ln
Norfolk VA 23507-1910
Phone: (757) 668-7007
Fax: (757) 668-8658
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Pathology | 207ZP0213X | 0101044312 | Virginia |
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 0101044312 | Virginia |
Profile Details
NPI number | 1013966563 |
---|---|
LBN Legal business name | Bergevin, Michael A. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 10th, 2006 |
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 | 1013966563 | NPPES |
Pennsylvania | MEDICAID | 0019185550001 | |
Pennsylvania | MEDICAID | 890511Y | |
Pennsylvania | MEDICAID | 2000076000 |
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