Individual provider · NPI-1

Dr. Stephen Bergman, D.O.

Family Medicine · Grants Pass, OR

NPI number1669475562
StatusActive
Last updated in NPPESJul 11, 2007

Details

NPI
1669475562
Entity type
Individual (NPI-1)
Name
Dr. Stephen Bergman
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
May 24, 2005
Last updated
Jul 11, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineDO21112ORYes

Practice location

741 Ne 6th St
Grants Pass, OR 97526-1556

Phone 541-471-2701 · Fax 541-471-1166

Mailing address

741 Ne 6th St
Grants Pass, OR 97526-1556

Phone 541-471-2701 · Fax 541-471-1166

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