# DR. MICHAEL BERGEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407116718
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | 0101267361 | VA | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 0101267361 | VA | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 35.146771 | OH | Yes |
| 208D00000X | General Practice Physician | 2756654 | NY | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NY | — |

## Other

- **Enumeration date:** 05/21/2012
- **Last updated:** 01/17/2023