Deane Bergsrud in Alexandria - Physician Assistant
Deane Bergsrud - NPI 1124234455
Deane Bergsrud is a Physician Assistant in Alexandria, Virginia. Deane Bergsrud practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Deane Bergsrud is 1124234455. The last update date is 2007-07-08.
Deane Bergsrud's current location address is 4660 Kenmore Ave, Alexandria, Virginia. You can contact this provider via phone number 7032120700 and fax number 7032120705. The mailing address for Deane Bergsrud is 4660 Kenmore Ave, Alexandria, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Deane Bergsrud |
|---|---|
| Address | 4660 Kenmore Ave, Alexandria, Virginia |
| Phone Number | 7032120700 |
| Fax Number | 7032120705 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1124234455 |
|---|---|
| Provider Enumeration Date | 2007-05-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4660 Kenmore Ave |
|---|---|
| City | Alexandria |
| State | Virginia (VA) |
| Post Code | 223041313 |
| Phone Number | 7032120700 |
| Fax Number | 7032120705 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 110000120 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique provider identifier assigned to Deane Bergsrud?
The Deane Bergsrud has been issued the NPI (National Provider Identifier) 1124234455 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Deane Bergsrud's physical address?
The Deane Bergsrud is physically located at 4660 Kenmore Ave, in the city of Alexandria, VA, with the postal code 223041313.
What is Deane Bergsrud's area of expertise and its corresponding taxonomy classification?
The Deane Bergsrud's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1124234455 assigned to Deane Bergsrud?
The Deane Bergsrud was issued its 1124234455 on 2007-05-15, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Deane Bergsrud last refreshed?
The information related to the Deane Bergsrud, including its address, specialty, and other relevant details, was last updated on 2007-07-08.