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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
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

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