Search › Georgia › 207Q00000X
Charles Bergstrom, M.D
NPI 1104886662 · on the registry since 2006
Practice
- Address
- 108 North Park Dr.
Fayetteville, GA 30214 - Phone
- (770) 461-3466
- Fax
- (770) 461-3884
- Organisation at this address
- John A Keller, Md, Pc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 174400000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-12-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia