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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
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