Individual
DR. MARK T BERGMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2859 BOUDINOT AVE, STE 301, CINCINNATI, OH 45238-1606
(513) 661-3566
(513) 661-6469
Mailing address
5535 FAIR LN, SUITE C, CINCINNATI, OH 45227-3434
(513) 221-5274
(513) 961-5100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-049117
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0688548
—
OH
01
—
180032729
RAILROAD MEDICARE
OH
Enumeration date
03/17/2006
Last updated
12/31/2013
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