Individual
DR. MICHAEL A BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2770 3RD AVE # S350, LAKE CHARLES, LA 70601-8994
(337) 494-6800
(337) 494-6811
Mailing address
PO BOX 122579, DEPT 2579, DALLAS, TX 75312-2579
(337) 494-6768
(337) 494-6792
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD25200
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1490334
—
LA
01
—
830008369
RAILROAD MEDICARE
LA
Enumeration date
03/21/2007
Last updated
07/24/2017
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