Organization
FORSYTH BONE DENSITY IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA K BERGMAN (PRESIDENT)
(336) 768-5355
Entity
Organization
Contact information
Practice address
1800 SOUTH HAWTHORNE ROAD, LOWER LEVEL, WINSTON SALEM, NC 27103-4047
(336) 768-5355
(336) 768-5121
Mailing address
1800 SOUTH HAWTHORNE ROAD, LOWER LEVEL, WINSTON SALEM, NC 27103-4047
(336) 768-5355
(336) 768-5121
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
Primary
773
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176T
BCBS
NC
01
—
19632
PARTNERS
NC
01
—
2901094
UNITED HEALTH
—
05
—
790176T
—
NC
Enumeration date
03/27/2007
Last updated
06/29/2010
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