Individual
MELANIE KIM BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 W 8TH AVE STE 1400, SPOKANE, WA 99204-2307
(509) 474-2200
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 474-2200
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
MD00041339
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139925
BLUE SHIELD OF IDAHO
—
01
—
0161207
LABOR & INDUSTRIES
WA
01
—
7711025
AETNA
—
05
—
806372200
—
ID
01
—
8095SN
ASURIS NW HEALTH
WA
05
—
8316663
—
WA
01
—
980000404
RAILROAD MEDICARE
—
01
—
KS038
BLUE CROSS OF IDAHO
—
Enumeration date
09/23/2005
Last updated
04/16/2021
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