Search › Minnesota › 363A00000X
Jack Bergman, PA-C
NPI 1043790553 · on the registry since 2018
Practice
- Address
- 3931 Louisiana Ave S
St Louis Park, MN 55426 - Phone
- (952) 993-3230
- Fax
- (952) 993-1748
- Organisation at this address
- Park Nicollet Health Care Products
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 162
Additional practice sites
- 5838 Six Forks Rd Ste 100, Raleigh, NC
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-01-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota