Bergman, Beth A.

Bergman, Beth A. is an individual health care provider with primary practice located at 2901 Greenbriar Dr , Springfield IL 62704-6425. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Bergman, Beth A. can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
2901 Greenbriar Dr Springfield IL 62704-6425
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 036-080163 Illinois

Profile Details

NPI number 1457461766
LBN Legal business name Bergman, Beth A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Dec 5th, 2008 - about 16 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 1457461766 NPPES
Illinois MEDICAID 036080163

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