Provider Demographics
NPI:1396741286
Name:BERGMAN, GARRETT EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:EDWARD
Last Name:BERGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9 SHIRLEY RD
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2015
Mailing Address - Country:US
Mailing Address - Phone:610-664-3218
Mailing Address - Fax:610-664-7442
Practice Address - Street 1:9 SHIRLEY RD
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2015
Practice Address - Country:US
Practice Address - Phone:610-667-4796
Practice Address - Fax:610-667-1986
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD012124E2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology