Individual
DR. JACQUELINE MAIDA BERGDOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 UCHEE PINES RD LOT 75, SEALE, AL 36875-5726
(334) 855-4764
(334) 855-9014
Mailing address
30 UCHEE PINES RD LOT 61, SEALE, AL 36875-5734
(334) 855-4765
(334) 855-9014
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301077244
MI
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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