Male or Other

Mr. Blake A. Bergeon MD

Physical Medicine & Rehabilitation Physician in Midland, MI(View on Map)

Full Name

Mr. Blake A Bergeon MD

NPI Number

1619953106

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/16/2005

Specialties

(Taxonomies)

Code

208100000X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

4301061418

Contact
Information

Purpose

Mailing
Location

Address

555 W WACKERLY ST
555 W WACKERLY ST

City

Midland
Midland

State

MI
MI

Postal Code

48640-4710
48640-4710

Country

US
US

Telephone Number

(989) 631-9267
(989) 631-9267

Identifiers

Identifier

3383068

Identifier State

MI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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