Individual
AUDREY BERGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
PO BOX 10, SPANISH FORK, UT 84660-0019
(330) 903-3294
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11439161-1205
UT
207P00000X
Emergency Medicine Physician
BP10049734
TX
207P00000X
Emergency Medicine Physician
Q9957
TX
Other
Enumeration date
04/16/2014
Last updated
12/22/2020
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