Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 32583 | MN |
NPI | 1144224007 |
---|---|
Provider Name | Vernon William Berglund |
First Address | Edina, MN 55435-5924 |
Second Address | Edina, MN 55435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 18/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110003C477 | UCARE (01) | MN |
110211566 | RR MEDICARE (01) | MN |
22542 | AMERICA'S PPO (01) | MN |
3200022 | MEDICA (01) | MN |
411774839A003 | CHAMPUS (01) | MN |
613708300 | (05) | MN |
66Q37BE | BLUE CROSS BLUE SHIELD (01) | MN |
960080512005 | PREFERRED ONE (01) | MN |
E90045 | (02) | MN |
HP12891 | HEALTHPARTNERS (01) | MN |