August Henry Bergman, M.D.

Individual provider Active NPI Internal Medicine Physician · Prescott, AZ

NPI 1184732604 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1184732604
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
11476 (NE)
Practice address
Northern Arizona VA HCS
500 N. Hwy 89
Prescott, AZ 86313
Phone
(928) 445-4860
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11476NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Vamc Past
since Sep 6, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11476 NE Yes

Addresses

Primary practice location

Northern Arizona VA HCS
500 N. Hwy 89
Prescott, AZ 86313

Mailing address

500 N. Hwy 89
Prescott, AZ 86313
Phone (928) 445-4860

Other providers in Prescott, AZ

All providers in Prescott, AZ · Internal Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.