Provider Demographics
NPI:1447280227
Name:NERGA, ALICJA BERNARDA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICJA
Middle Name:BERNARDA
Last Name:NERGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2891 E MAPLE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-6106
Mailing Address - Country:US
Mailing Address - Phone:248-524-9085
Mailing Address - Fax:248-524-9086
Practice Address - Street 1:2891 E MAPLE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-6106
Practice Address - Country:US
Practice Address - Phone:248-524-9085
Practice Address - Fax:248-524-9086
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIAN071911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4269907Medicaid
MI700F32572OtherBCBS PROVIDER ID NO.
MI4269907Medicaid
MI700F32572OtherBCBS PROVIDER ID NO.