Dr. Kelly Robert Bergmann
Pediatric Emergency Physician
2525 Chicago Ave
Minneapolis
, Minnesota 55404-4518
Dr. Kelly Robert Bergmann
Pediatric Emergency Physician
2525 Chicago Ave
Minneapolis
, Minnesota 55404-4518
(952) 334-5309
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About
Features
Specialties
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. Kelly Robert Bergmann
- 14 E 49th St
- Minneapolis, MN
- Zip : 55419-5613
- Phone : (952) 334-5309
Second Address
- Dr. Kelly Robert Bergmann
- 2525 Chicago Ave
- Minneapolis, MN
- Zip : 55404-4518
- Phone : (952) 334-5309
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | 54669 | MN |
National Provider Identifier
| NPI | 1790002129 |
|---|---|
| Provider Name | Dr. Kelly Robert Bergmann |
| First Address | Minneapolis, MN 55419-5613 |
| Second Address | Minneapolis, MN 55404-4518 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/04/2010 |
| Last Update Date | 15/02/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.