Provider Demographics
NPI:1265841373
Name:BERGERON, CHRISTINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:BERGERON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 MACHINE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN PROVING GROUND
Mailing Address - State:MD
Mailing Address - Zip Code:21005-5213
Mailing Address - Country:US
Mailing Address - Phone:410-278-1936
Mailing Address - Fax:
Practice Address - Street 1:6455 MACHINE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN PROVING GROUND
Practice Address - State:MD
Practice Address - Zip Code:21005-5213
Practice Address - Country:US
Practice Address - Phone:410-278-1936
Practice Address - Fax:410-278-3520
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist