1902484934 NPI number — SCOTT HILLIARD BERG

Table of content: SCOTT HILLIARD BERG (NPI 1902484934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902484934 NPI number — SCOTT HILLIARD BERG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERG
Provider First Name:
SCOTT
Provider Middle Name:
HILLIARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902484934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 LEE ST
Provider Second Line Business Mailing Address:
P.O. BOX 800718, UVA HEALTH SYSTEM
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-924-5115
Provider Business Mailing Address Fax Number:
434-244-4504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1221 LEE ST
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-924-5115
Provider Business Practice Location Address Fax Number:
434-244-4504
Provider Enumeration Date:
03/31/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com