DR. GUNNAR EO BERGQVIST (NPI# 1649216524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649216524 |
| Entity Type | Individual |
| Full Name | DR. GUNNAR EO BERGQVIST |
| Credential | M.D. |
| Practice Address |
410 Cranberry St Suite 310 Erie PA 16507-1067 |
| Practice Telephone | 8144808220 |
| Practice Fax Number | 8144808225 |
| Mailing Telephone | 8144808220 |
| Mailing Fax Number | 8144808225 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-05-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
MD418581 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
410 CRANBERRY ST SUITE 310 |
| City | ERIE |
| State | PA |
| Zip Code | 16507-1067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881900959 | Casey Dye | Licensed Practical Nurse | 410 Cranberry St, Suite 210, Erie, PA 16507-1067 | 2010-08-26 |
| 1023268232 | Trusted & Reliable Healthcare, Inc. | Home Health | 410 Cranberry St, Suite 210, Erie, PA 16507-1067 | 2008-09-24 |
| 1982802377 | Lee J Simon | Dentist | 410 Cranberry St, Suite 300, Erie, PA 16507-1067 | 2007-07-06 |
| 1700082633 | Prabhaker Sardesai | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 410 Cranberry St, Suite 120, Erie, PA 16507-1067 | 2007-06-26 |
| 1609987759 | Plastic Surgery Center of Pa | Plastic Surgery | 410 Cranberry St, Suite 310, Erie, PA 16507-1067 | 2006-08-31 |
| 1457389694 | Medical Diagnostic Services, Ltd. | Specialist | 410 Cranberry St, Erie, PA 16507-1067 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275198723 | Ram Baboo | Student in an Organized Health Care Education/Training Program | 120 East 2nd Street Upmc Northshore Neurology, 3rd Floor, Erie, PA 16507 | 2019-05-09 |
| 1518431915 | Katrina L Putnam | Social Worker | 101 East Avenue, Erie, PA 16507 | 2019-01-18 |
| 1144712084 | Kathlyn Elise Callenius | Student in an Organized Health Care Education/Training Program | 120 East Second St, 3rd Floor, Erie, PA 16507 | 2018-06-06 |
| 1043707490 | Cecelia Anne Hollands | Counselor | 103 East Ave., Erie, PA 16507 | 2018-04-20 |
| 1336591239 | Zachary Dusckas | Student in an Organized Health Care Education/Training Program | 100 Peach St #400, Orthopaedics & Sports Medicine of Erie, Erie, PA 16507 | 2016-07-05 |
| 1679928329 | Stephanie Libra | Occupational Therapist | 100 Barber Place, Box # 29, Erie, PA 16507 | 2016-05-02 |
| 1821476243 | Colin Macelroy Vroome Jr. | Orthopaedic Surgery | Hand, Microsurgery, Reconstructive Orthopedics, LLP, 300 State St. Suite 205, Erie, PA 16507 | 2015-05-18 |
| 1255742227 | Danoushka Tememe | Psychiatry & Neurology | 120 East Second St., 3rd Floor, Erie, PA 16507 | 2014-05-13 |
| 1811307507 | David Aaron Hammer | Psychiatry & Neurology | 120 E Second Street Upmc North Shore Neurology, 7rd Floor, Erie, PA 16507 | 2014-05-02 |
| 1912330325 | Jeanine Krugger | Pharmacist | 363 East 6th St, Erie, PA 16507 | 2013-08-21 |
| Find all providers in zip 16507 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154483030 | Today's Cosmetic Surgery and Laser Center, P.C. | Plastic Surgery | 100 Stoops Dr Ste 240, Monongahela, PA 15063-3553 | 2006-12-15 |
| 1619163706 | Aesthetic Facial Plastic Surgery Center, Inc. | Plastic Surgery | 101 Chesley Dr, Georgtown Building, Media, PA 19063-1761 | 2007-09-21 |
| 1326151499 | Wendell Lavern Funk | Plastic Surgery | 230 Harrisburg Ave, Suite 7, Lancaster, PA 17603-2959 | 2006-08-15 |
| 1992742282 | Jonathan Pontell | Plastic Surgery | 303 W Lancaster Ave, Suite 1a, Wayne, PA 19087-3938 | 2006-06-02 |
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| 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.