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Individual

ROY THOMAS BERGMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
MD00029374
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD00029374
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891860979
WA
01
315943
L&I POST 7/21/13
WA
01
P01256584
RR MEDICARE
WA
Enumeration date
11/22/2006
Last updated
02/11/2014
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