Individual
JORGE J BERGESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-1125
(419) 756-1825
Mailing address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-1125
(419) 756-1825
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35.038255
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0332376
—
OH
Enumeration date
09/15/2006
Last updated
07/08/2007
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