Individual
DR. DEREK SCOTT BERGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-8460
(801) 354-8225
(801) 418-0941
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12767278-1205
UT
Other
Enumeration date
04/25/2007
Last updated
03/04/2025
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