Bergstrom, Robert W
Bergstrom, Robert W is an individual health care provider with primary practice located at 831 Nw Council Dr Suite 125, Gresham OR 97030-3721. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bergstrom, Robert W can be contacted via phone (503) 661-3439.Contact Information
Primary practice address
831 Nw Council Dr Suite 125
Gresham OR 97030-3721
Phone: (503) 661-3439
Fax: (503) 669-1360
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD24029 | Oregon |
Profile Details
NPI number | 1982660700 |
---|---|
LBN Legal business name | Bergstrom, Robert W |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 21st, 2006 |
Last updated | Mar 17th, 2010 - about 14 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 | 1982660700 | NPPES |
Washington | MEDICAID | 8372849 | |
Washington | MEDICAID | 286638 |
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