Provider Demographics
NPI:1578783551
Name:BERGIN, TROY (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:BERGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19567 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-3201
Mailing Address - Country:US
Mailing Address - Phone:574-277-7600
Mailing Address - Fax:574-277-7690
Practice Address - Street 1:19567 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-3201
Practice Address - Country:US
Practice Address - Phone:574-277-7600
Practice Address - Fax:574-277-7690
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036878A2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine