Individual
DR. JOSEPH EDWARD BERGSTROM SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 W KIMBERLY RD, DAVENPORT, IA 52806-3059
(563) 421-1000
Mailing address
3200 W KIMBERLY RD, DAVENPORT, IA 52806-3059
(563) 421-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03192
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00363057
RR MEDICARE
IA
Enumeration date
04/20/2006
Last updated
10/03/2021
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