Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Charles A Bergstrom, MD

Individual provider Specialist · NPI 1104886662

Dr. Charles A Bergstrom, MD is a Specialist in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

108 N Park Dr
Fayetteville, GA 30214
Phone: (770) 461-3466
Fax: (770) 461-3884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 033030 (GA)
Specialist Taxonomy 174400000X · Licence 033030 (GA)

Record details

NPI number1104886662
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2006
Last updated in NPPESDecember 30, 2021
Certification dateDecember 30, 2021
Mailing address108 N Park Dr, Fayetteville, GA 30214-1645

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