Linda Olson Bergum, MD
Individual provider Active NPI Family Medicine Physician · Kotzebue, AK
NPI 1295795342 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1295795342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 30884 (MN)
- Practice address
- 436 5TH Avenue
Kotzebue, AK 99752 - Phone
- (907) 442-3321
- NPI assigned
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30884 | MN | MD | Family Medicine Physician |
| 2657 | AK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Past | Accepting new patients | |
| University of Minnesota Physicians | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30884 | MN | Yes |
| Family Medicine Physician | 207Q00000X | 2657 | AK |
Addresses
Primary practice location
436 5TH Avenue
Kotzebue, AK 99752
Mailing address
PO Box 43
Kotzebue, AK 99752-0043
Phone (907) 442-3321
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122344 | Other | MN | MEDICA |
| HP10118 | Other | MN | BCBS |
Other providers in Kotzebue, AK
- Norma Ballot
- Evelyn Mary Barr
- Melinda Barr
- Kirsten Beecroft
- Brandon Alexander Berger
- Maylani Bernhardt
- Jessica Marie Bird
- Doreen Blake
- Magdeline L Booth
- Mildred Booth
All providers in Kotzebue, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.