NPI 1861466583 · live from the CMS NPI Registry
Randall P. Bergen, DPM
Podiatrist in Sioux City, IA. National Provider Identifier 1861466583, active.
NPI record
| NPI | 1861466583 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 505 5th St, Suite 714, Sioux City, IA 51101 |
| Practice phone | 712-255-3526 |
| Mailing address | 505 5th St Ste 714, Sioux City, IA 51101 |
| Enumerated | February 17, 2006 |
| Last updated | May 14, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 00319 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.