Individual
DR. ERICK J. BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 W 2ND AVE, LATROBE, PA 15650-1068
(412) 920-5860
(412) 920-5861
Mailing address
640 KOLTER DR, INDIANA, PA 15701-3570
(724) 357-7196
(724) 357-7279
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD015265E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007280820001
—
PA
Enumeration date
04/13/2006
Last updated
03/10/2021
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