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Organization

PENNSYLVANIA INTERNAL MEDICINE & GERIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HERBERT M BERGMAN M.D (PHYSICIAN)
(215) 637-0102
Entity
Organization

Contact information

Practice address
9503 STATE RD, PHILADELPHIA, PA 19114-3034
(215) 637-0102
(215) 281-0464
Mailing address
9501 HILSPACH ST, PHILADELPHIA, PA 19115-3918
(215) 637-0102
(215) 281-0464

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD012582E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000592556
PA
01
0053907001
KEYSTONE HEALTH PLAN EAST
PA
01
035806
HIGHMARK MEDICARE SERVICES
PA
01
110026458
PALMETTO GBA MEDICARE RAILROAD
PA
01
129328701
UNITED HEALTHCARE
PA
01
19361
BRAVO HEALTHCRE
PA
01
835253
AETNA INSURANCE
PA
Enumeration date
01/05/2009
Last updated
10/14/2009
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