Individual
DR. ROGER L. BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
585 MAIN ST, LEWISTON, ME 04240-5945
(207) 784-0153
(207) 786-6725
Mailing address
585 MAIN ST, LEWISTON, ME 04240-5945
(207) 784-0153
(207) 786-6725
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT598
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114880099
—
ME
01
—
410002654
RAILROAD MEDICARE-UHC
ME
Enumeration date
12/15/2006
Last updated
03/15/2008
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