Bergman, Kenneth R

Bergman, Kenneth R is an individual health care provider with primary practice located at 14631 Lee Hwy Ste 413, Centreville VA 20121-5824. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Bergman, Kenneth R can be contacted via phone (703) 385-8222.

Contact Information

Primary practice address
14631 Lee Hwy Ste 413 Centreville VA 20121-5824
Phone: (703) 385-8222
Fax: (703) 832-8809
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 0101102580 Virginia

Profile Details

NPI number 1659349447
LBN Legal business name Bergman, Kenneth R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Dec 11th, 2014 - about 11 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 1659349447 NPPES
Virginia Other P00406443 RR MEDICARE

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