Individual
DANIELLE MARIE BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 679-1313
Mailing address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 679-1313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50768
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131479
MEDICA
—
05
—
243490100
—
MN
01
—
704K0BE
BCBS MN
—
01
—
P00633198
RAILROAD MEDICARE
—
Enumeration date
08/05/2007
Last updated
11/08/2023
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