Individual
DR. RICHARD M BERGENSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3393
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-1913
(952) 993-1302
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
28104
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
416067300
—
MN
Enumeration date
12/27/2005
Last updated
10/20/2011
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