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Individual

DR. MICHAEL A. BERGEVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7007
(757) 668-8658
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101044312
VA
207ZP0213X
Pediatric Pathology Physician
0101044312
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019185550001
PA
05
2000076000
WV
05
890511Y
NC
Enumeration date
05/10/2006
Last updated
09/11/2025
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