Individual
DR. KENT DAVIS BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 KENNARD ST, SUITE 100 HEALTHEAST PHYSICIAN SERVICE,, MAPLEWOOD, MN 55109
(651) 232-7800
Mailing address
3100 KENNARD ST, SUITE 100 HEALTHEAST MAPLEWOOD CLINIC,, MAPLEWOOD, MN 55109
(651) 232-7800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21143
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-22438
MEDICA CHOICE & PRIMARY
MN
01
—
1000069
PREFERRED ONE
MN
01
—
102680
UCARE
MN
05
—
1540237
—
IA
05
—
341595300
—
MN
01
—
411743943
TRIWEST
MN
01
—
66-07567
MEDICA CHOICE
MN
01
—
768021
ARAZ
MN
01
—
97384BE
BCBS
MN
01
—
HP20018
HEALTHPARTNERS
MN
Enumeration date
06/19/2006
Last updated
06/08/2010
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