Individual
A. GABRIELLE BERGMAN
Active
Individual
A. GABRIELLE BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A45426
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391170
BCBS
OH
01
—
00A454260
BCBS
CA
05
—
00A454260
—
CA
05
—
23482101
—
AZ
05
—
2510143
—
OH
05
—
3002596
—
TN
05
—
807558000
—
ID
01
—
P00146079
RXR MCR
—
Enumeration date
11/09/2005
Last updated
03/26/2013
Update your record
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