Individual
MRS. MARY E. BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
KENNER ARMY HEALTH CLINIC, 700 24TH ST, FORT LEE, VA 23801
(804) 734-9491
Mailing address
KENNER ARMY HEALTH CLINIC, 700 24TH ST, FORT LEE, VA 23801
(804) 734-9491
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003446
VA
Other
Enumeration date
12/30/2010
Last updated
03/07/2023
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