Bergsma, Corwyn B

Bergsma, Corwyn B is an individual health care provider with primary practice located at 1195 Wilson Ave Nw Suite 200, Grand Rapids MI 49534-6405. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Bergsma, Corwyn B can be contacted via phone (616) 453-8277.

Contact Information

Primary practice address
1195 Wilson Ave Nw Suite 200 Grand Rapids MI 49534-6405
Phone: (616) 453-8277
Fax: (616) 453-2002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5901002157 Michigan

Profile Details

NPI number 1447281662
LBN Legal business name Bergsma, Corwyn B
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Dec 27th, 2021 - about 4 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 1447281662 NPPES
Michigan Other 1266510001 ADMINISTAR
Michigan MEDICAID 4584211 ADMINISTAR
Michigan Other 480026386 ADMINISTAR

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