Individual
CARLOS BERMEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3175
(607) 547-6553
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 547-3175
(607) 547-6553
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
248945
NY
208800000X
Urology Physician
L3578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166962401
—
TX
Enumeration date
08/24/2006
Last updated
01/21/2011
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