Individual
DR. JAROD BERGGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8000
Mailing address
555 W WALNUT ST APT 207, ALLENTOWN, PA 18101-2337
(303) 502-4203
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT220553
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT220553
STATE LICENSE NUMBER
PA
Enumeration date
05/22/2020
Last updated
05/22/2020
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