Bergman, Kenneth S
Bergman, Kenneth S is an sole proprietor health care provider with primary practice located at 11511 Canterwood Blvd Nw Suite 50, Gig Harbor WA 98332-5813. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Bergman, Kenneth S can be contacted via phone (253) 851-5155.Contact Information
Primary practice address
11511 Canterwood Blvd Nw Suite 50
Gig Harbor WA 98332-5813
Phone: (253) 851-5155
Fax: (253) 851-5367
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | MD00030100 | Washington |
Profile Details
| NPI number | 1669443032 |
|---|---|
| LBN Legal business name | Bergman, Kenneth S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Aug 28th, 2012 - about 12 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 | 1669443032 | NPPES |
| Washington | MEDICAID | 8293987 |
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