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Dr. Charles A Bergstrom, MD
Family Medicine Physician in Fayetteville, Georgia
NPI 1104886662

Charles A Bergstrom is a Family Medicine Physician based in Fayetteville, GA. Charles A Bergstrom practices in Fayetteville, GA and has the professional credentials of MD. The NPI Number for Charles A Bergstrom is 1104886662 and holds a License No. 033030 (Georgia).

The current practice location address for Charles A Bergstrom is 108 North Park Dr., Fayetteville, GA and can be reached out via phone at 770-461-3466 and via fax at 770-461-3884.

Location: 108 North Park Dr., Fayetteville, GA, 30214-1645
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104886662
Provider Name
Charles A Bergstrom
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
108 North Park Dr., Fayetteville, GA, 30214-1645
Phone Number
770-461-3466
Fax Number
770-461-3884
Provider Enumeration Date
03/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104886662 01 GA NPI
52030615 01 GA BCBS OF GA
institution
Provider Business Practice Location Address Details
Address
108 North Park Dr.
City
Fayetteville
State
Georgia
Zip
30214
Phone Number
770-461-3466
Fax Number
770-461-3884
person
Provider Business Mailing Address Details
Address
108 North Park Dr.
City
Fayetteville
State
Georgia
Zip
30214
Phone Number
770-461-3466
Fax Number
770-461-3884
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
033030 (Georgia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
033030 (Georgia)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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