Individual
MR. JOHN MICHAEL BERGMAN
Active
Individual
MR. JOHN MICHAEL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED PSYCHOLOGIS
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
00505
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058230
—
IA
01
—
037087
HEALTH ALLIANCE
IA
01
—
05823
BCBS
IA
01
—
234211
MIDLANDS CHOICE
IA
01
—
IA0101
JOHN DEERE/UBH
IA
Enumeration date
02/15/2006
Last updated
10/10/2007
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