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1104591874
MAX FREDERICK BERGSTROM
STATESVILLE, NC
NPI
1104591874
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-11420)
Enumeration Date
2021-08-13
Last Update Date
2024-07-22
Business Address
MR. MAX FREDERICK BERGSTROM PA-C
705 GAITHER RD
STATESVILLE, NC 28625-3450
Phone number: 704-871-1155
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Mailing Address
MR. MAX FREDERICK BERGSTROM PA-C
PO BOX 1845
STATESVILLE, NC 28687-1845
Phone number: 704-873-4277
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