Individual
MARK BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(440) 205-5703
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
102645
MN
207RH0003X
Hematology & Oncology Physician
Primary
35090582
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226038
UNISON
OH
01
—
000000541302
ANTHEM
OH
01
—
000000545329
ANTHEM
OH
05
—
006957000
—
MN
01
—
133208
UCARE MN
MN
01
—
2444004
AMERICA'S PPO
MN
05
—
2774654
—
OH
05
—
34890000
—
WI
01
—
3600665
MEDICA
MN
01
—
421770
WELLCARE
OH
01
—
490P0BE
BLUE CROSS BLUE SHIELD
MN
01
—
751099
BUCKEYE
OH
01
—
7795076
AETNA
OH
01
—
HP69898
HEALTHPARTNERS
MN
01
—
P00459854
RAILROAD MEDICARE
OH
Enumeration date
08/11/2006
Last updated
06/28/2011
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