Individual
CRAIG BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
717 S STATE ST STE 100, FAIRMONT, MN 56031-4470
(507) 235-3939
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R142187-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F96BE
BLUE CROSS OF MN
MN
05
—
803519900
—
MN
Enumeration date
04/20/2006
Last updated
10/13/2017
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