Individual
MR. PETER E BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6600 E 2ND STREET, CASPER, WY 82609-4348
(307) 266-4000
(307) 995-8112
Mailing address
PO BOX 51888, CASPER, WY 82605-1888
(307) 266-4000
(307) 995-8112
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
452
NE
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
8467A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
248334
MIDLANDS CHOICE
NE
01
—
35600
BCBSNE
NE
01
—
84-1102490
UNITED HEALTH CARE
NE
01
—
P00307203
RR
NE
Enumeration date
06/10/2006
Last updated
04/02/2012
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