Individual
ELIZA A BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-8100
(608) 263-0575
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100023498
—
WI
Enumeration date
05/18/2012
Last updated
02/04/2025
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