NPI age
20 years
Enumerated 2006-03-27
● Active
Type 1 · Individual
DR. Charles A Bergstrom, M.D.
Bergstrom is 1 of 40 family medicine providers in Fayetteville and 1 of 5448 in Georgia.
Primary specialty
Family Medicine
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-12-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5448 active family medicine providers in Georgia.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
1 state
12% of peers hold multiple states
Subspecialties
1
In the 26% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-03Enumerated in NPPES
2006
2026
Where they practice
Practice location
108 North Park Dr.
Fayetteville, GA 30214
Mailing address
108 N Park Dr
Fayetteville, GA 302141645
Specialties
-
Family Medicine PrimaryFamily 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...
-
SpecialistAn 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1104886662 | NPI |
| 01 (GA) | 52030615 | BCBS OF GA |
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new family medicine provider has been added in Fayetteville in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.