Search › Wisconsin › 363A00000X
Mallorie Bergstrom, PA-C
NPI 1730490012 · on the registry since 2010
Practice
- Address
- 2727 N Mayfair Rd Ste I
Wauwatosa, WI 53222 - Phone
- (414) 727-0910
- Fax
- (414) 727-0920
- Organisation at this address
- Alliance Ent And Hearing Center, Sc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-05-02
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 Wisconsin