Internal Medicine & Aesthetics
NPI 1780442103ActiveOrganization· Internal Medicine· Portage, MI
Internal Medicine in Portage, Michigan, registered in NPPES in March 2024. The authorized official on file is Julie Bergman, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1780442103 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 11, 2024 |
| Last updated in NPPES | Mar 11, 2024 |
| Certified by provider | Mar 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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