DR. GLYNN A BERGERON (NPI# 1578566352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578566352 |
| Entity Type | Individual |
| Full Name | DR. GLYNN A BERGERON |
| Credential | M.D. |
| Practice Address |
6 Wheeler Ct Savannah GA 31405-5719 |
| Mailing Address |
Po Box 14416 Savannah GA 31416-1416 |
| Practice Telephone | 9123558200 |
| Practice Fax Number | 9123566967 |
| Mailing Telephone | 9123558200 |
| Mailing Fax Number | 9123566967 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
19482 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00153029A | 05 | |
| GA | BLUE CROSS BLUE SHIELD | 003681 | 01 |
| Street Address |
6 WHEELER CT |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-5719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992708796 | Sanford Victor Berens | Radiology | 6 Wheeler Ct, Savannah, GA 31405-5719 | 2005-05-24 |
| 1467401984 | Diagnostic Health Corporation | Physiological Laboratory | 6 Wheeler Ct, Savannah, GA 31405-5719 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811361108 | York Neurology Group | Radiology | 35 Barnard St, Suite 300, Savannah, GA 31401-2500 | 2015-11-24 |
| 1083949267 | James A Long | Radiology | 503 Eisenhower Drive, Savannah, GA 31406 | 2009-10-06 |
| 1518064237 | Diagnostic Systems Inc | Radiology | 4815 Waters Ave, Savannah, GA 31404 | 2006-09-17 |
| 1285663443 | Chatham Radiologists, Pa | Radiology | 5354 Reynolds St., Ste. 102, Savannah, GA 31405-6008 | 2006-07-01 |
| 1184650566 | Dale Nance | Radiology | 340 Eisenhower Dr Ste 1305, Savannah, GA 31406-1607 | 2006-06-25 |
| 1952368672 | James Henry Algeo Jr. | Radiology | 935 Wayne Rd, Savannah, TN 38372-1904 | 2006-04-27 |
| 1356326557 | William Gordon Greene | Radiology | 529 Stephenson Ave, Suite 5, Savannah, GA 31405-5984 | 2005-12-09 |
| 1205834066 | Lois Elizabeth Curry | Radiology | 4 Monastery Rd W, Savannah, GA 31411-1714 | 2005-07-14 |
| 1992708796 | Sanford Victor Berens | Radiology | 6 Wheeler Ct, Savannah, GA 31405-5719 | 2005-05-24 |
| 1295738086 | Pamela Boland | Radiology | 1326 Eisenhower Dr, Savannah, GA 31406-3928 | 2005-05-24 |
| Find all providers in SAVANNAH | ||||
Please comment or provide details below to improve the information on DR. GLYNN A BERGERON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.