Individual
DR. KENNETH BERGSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27207 LAHSER RD, SUITE 200 B, SOUTHFIELD, MI 48034-2168
(248) 358-4892
Mailing address
PO BOX 321061, DETROIT, MI 48232-1061
(248) 543-8070
(248) 543-9005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301028293
MI
207RH0003X
Hematology & Oncology Physician
4301028293
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4482104
—
MI
Enumeration date
06/12/2006
Last updated
08/18/2010
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