Individual
MR. THOMAS PAUL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(612) 863-6590
Mailing address
6025 LAKE RD STE 200, WOODBURY, MN 55125-1710
(651) 999-6800
(651) 999-6970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12457
MN
Other
Enumeration date
05/02/2017
Last updated
06/16/2020
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