Individual
THOMAS MARK BERTAGNOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-9612
Mailing address
88MDG/SGHJ, 4881 SUGAR MAPLE DR, WRIGHT-PATTERSON AFB, OH 45433-5529
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1611
NE
Other
Enumeration date
04/20/2015
Last updated
08/03/2023
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