Individual
MICHAEL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6327 S GRAND BLVD, APT 1G, SAINT LOUIS, MO 63111-2653
(314) 333-2103
Mailing address
6327 S GRAND BLVD, APT 1G, SAINT LOUIS, MO 63111-2653
(314) 333-2103
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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