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Individual

DR. JERRY MICHAEL BERGSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8905 SOURWOOD CT, INDIANAPOLIS, IN 46260-1544
(317) 872-4459
(317) 872-4459
Mailing address
8905 SOURWOOD CT, INDIANAPOLIS, IN 46260-1544
(317) 872-4459
(317) 872-4459

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01027479A
IN

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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