Individual
DYLAN BERGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-4600
Mailing address
45439 COUNTY ROAD 358, PAW PAW, MI 49079-8715
(269) 808-6747
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101026786
MI
390200000X
Student in an Organized Health Care Education/Training Program
5101021786
MI
390200000X
Student in an Organized Health Care Education/Training Program
5151014703
MI
Other
Enumeration date
05/20/2020
Last updated
08/15/2022
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