Organization
MARTIN JAN BERGMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN JAN BERGMAN MD (OWNER)
(610) 521-1701
Entity
Organization
Contact information
Practice address
23 W CHESTER PIKE, SUITE 201, RIDLEY PARK, PA 19078-1629
(610) 521-1701
(610) 521-9450
Mailing address
23 W CHESTER PIKE, SUITE 201, RIDLEY PARK, PA 19078-1629
(610) 521-1701
(610) 521-9450
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD 030099E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010798830002
—
PA
01
—
043725
PTAN
—
Enumeration date
12/15/2014
Last updated
07/16/2019
Update your record
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