Individual
EDWARD JOSEPH BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 SIXTH ST STE 202, TRAVERSE CITY, MI 49684-2359
(231) 935-5730
(231) 935-5736
Mailing address
1221 SIXTH ST STE 202, TRAVERSE CITY, MI 49684-2359
(231) 935-5730
(231) 935-5736
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301086049
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301086049
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
CO
Other
Enumeration date
07/23/2007
Last updated
04/16/2021
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