Individual
CORY BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 719-3110
(605) 341-0278
Mailing address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 719-3110
(605) 341-0278
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12382
SD
207W00000X
Ophthalmology Physician
13306A
WY
207W00000X
Ophthalmology Physician
33318
NE
207W00000X
Ophthalmology Physician
60841848
WA
207W00000X
Ophthalmology Physician
A141899
CA
390200000X
Student in an Organized Health Care Education/Training Program
TL.0005316
CO
Other
Enumeration date
06/21/2014
Last updated
03/15/2021
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