Bertie, Richard C

Bertie, Richard C is an individual health care provider with primary practice located at 9055 Springbrook Dr Nw , Coon Rapids MN 55433-5841. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bertie, Richard C can be contacted via phone (763) 780-9155.

Contact Information

Primary practice address
9055 Springbrook Dr Nw Coon Rapids MN 55433-5841
Phone: (763) 780-9155
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24188 Minnesota

Profile Details

NPI number 1558321620
LBN Legal business name Bertie, Richard C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Oct 21st, 2011 - about 13 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 1558321620 NPPES
Minnesota MEDICAID 164792000

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