Dr. Theodore J Bergstrom
M.D. | Pediatrics | Male
Dr. Theodore J Bergstrom, M.D. is a Walla Walla, Washington based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Theodore J Bergstrom is
55 W Tietan St, Walla Walla, Washington - 99362-4445. He can be contacted on phone at
509-525-3720 and fax number 509-522-1578.
Dr. Theodore J Bergstrom is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Theodore J Bergstrom is
1598739716 which was assigned by NPPES on 14 Feb, 2006 and it was last updated on 27 Nov, 2007.
Dr. Theodore J Bergstrom license number is
MD00022923 for Pediatrics (208000000X) in Washington.
Dr. Theodore J Bergstrom is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Theodore J Bergstrom basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Theodore J Bergstrom |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dr. Theodore J Bergstrom address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 55 W Tietan St
Walla Walla, WA, 99362-4445
United States |
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| Phone Number : | 509-525-3720 |
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| Fax Number : | 509-522-1578 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1598739716 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 14 Feb, 2006 |
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| Last Updated On : | 27 Nov, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Theodore J Bergstrom are as mentioned. Primary taxonomy code for Dr. Theodore J Bergstrom, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | MD00022923 | WA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Theodore J Bergstrom such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 152421 | MEDICAID | OR | |
| 10041910 | Other | WA | RAIL ROAD MEDICARE |
| 40225 | Other | WA | L&I |
| 1007525 | MEDICAID | WA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 55 W Tietan St
Walla Walla, WA, 99362-4445
United States |
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| Phone Number : | 509-525-3720 |
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| Fax Number : | 509-522-1592 |
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Business Location:
Patients can refer following map for directions to
Dr. Theodore J Bergstrom practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.