Provider Demographics
NPI:1306188552
Name:PRICE, JESSICA BERGQUIST (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BERGQUIST
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:NICOLE
Other - Last Name:BERGQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:816 MIDDLE STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2582
Mailing Address - Country:US
Mailing Address - Phone:412-321-4001
Mailing Address - Fax:412-321-4063
Practice Address - Street 1:816 MIDDLE STREET
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2582
Practice Address - Country:US
Practice Address - Phone:412-321-4001
Practice Address - Fax:412-321-4063
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics