Individual
JAMES JAY BERGMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 PLEASANT ST, SUITE 400, DES MOINES, IA 50309-1416
(515) 241-5722
(515) 241-4403
Mailing address
11304 ELK HORN ST, NORWALK, IA 50211-9568
(515) 961-7023
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17916
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073395
—
IA
01
—
07339
BLUE SHIELD PROVIDER #
IA
01
—
17916
TRICARE PROVIDER #
IA
01
—
4278
MIDLANDS PROVIDER #
IA
01
—
IA0112
JOHN DEERE PROVIDER #
IA
Enumeration date
12/22/2005
Last updated
07/09/2007
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