Organization
PENRAD IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK SCOTT BERGESON MD (RADIOLOGIST)
(719) 593-1799
Entity
Organization
Contact information
Practice address
4105 BRIARGATE PKWY STE 115, COLORADO SPRINGS, CO 80920-3482
(719) 593-1799
(719) 265-3794
Mailing address
PO BOX 2989, COLORADO SPRINGS, CO 80901-2989
(719) 593-1799
(719) 265-3794
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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