Provider Demographics
NPI:1760406375
Name:BERGLUND, LAURA H (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:H
Last Name:BERGLUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4315 BEN FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2145
Mailing Address - Country:US
Mailing Address - Phone:919-477-7773
Mailing Address - Fax:919-477-7375
Practice Address - Street 1:3940 ARROWHEAD BLVD STE 225
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7637
Practice Address - Country:US
Practice Address - Phone:919-563-3007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8915089Medicaid
NC8915089Medicaid
NCF33048Medicare UPIN