Petersen, Diane Elaine Bergman

Petersen, Diane Elaine Bergman is an individual health care provider with primary practice located at 940 Central Park Drive #209, Steamboat Springs CO 80487. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Petersen, Diane Elaine Bergman can be contacted via phone (970) 879-3738.

Contact Information

Primary practice address
940 Central Park Drive #209 Steamboat Springs CO 80487
Phone: (970) 879-3738
Fax: (970) 870-6441
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 30507 Minnesota
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 46731 Colorado

Profile Details

NPI number 1013939578
LBN Legal business name Petersen, Diane Elaine Bergman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Aug 3rd, 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 1013939578 NPPES
Colorado Other 46731 COLORADO STATE LICENSE

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