Bergman, Stuart M.
Bergman, Stuart M. is an individual health care provider with primary practice located at 775 Pole Line Rd W Ste 301 , Twin Falls ID 83301-5823. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Bergman, Stuart M. can be contacted via phone (208) 814-8700.Contact Information
Primary practice address
775 Pole Line Rd W Ste 301
Twin Falls ID 83301-5823
Phone: (208) 814-8700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | M-15122 | Idaho |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD465614 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ME100410 | Florida |
Profile Details
| NPI number | 1992859805 |
|---|---|
| LBN Legal business name | Bergman, Stuart M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Jul 3rd, 2024 - about 2 months 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 | 1992859805 | NPPES |
| Other | 10381145 | CAQH | |
| Other | P110118 | CAQH | |
| MEDICAID | 103625804 | CAQH | |
| Other | 5248030 | CAQH | |
| Other | 2292290 A | CAQH | |
| MEDICAID | 000256000 | CAQH | |
| Other | 10H686 | CAQH | |
| Other | 1192907 | CAQH | |
| Other | P01195011 | CAQH | |
| Other | 47450 | CAQH | |
| Other | 8533707 | CAQH | |
| Other | 325061 | CAQH | |
| MEDICAID | 7595816 | CAQH |
Popular Providers
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Tall, Roger H
2001 S Woodruff Suite 8, Idaho Falls ID 83404 -
Taylor, Timothy Osborn
2330 Coronado St , Idaho Falls ID 83404-7407 -
Zausmer, Glenn D
775 Pole Line Rd W Suite 301, Twin Falls ID 83301-5814 -
Manwaring, Jared K.
2375 Coronado St , Idaho Falls ID 83404-7407 -
Hancock, Joel
2114 Village Park Ave , Twin Falls ID 83301-4172 -
Blatter, Richard Alan
2001 S Woodruff Ave Ste 4 , Idaho Falls ID 83404-6371 -
Harris, Duncan Dwaynne
3200 Channing Way Ste A205 , Idaho Falls ID 83404-7586 -
Mazzone, Andrew
775 Pole Line Rd W Ste 301 , Twin Falls ID 83301-5823