NPI 1891988242

Ethan Schuyler Bergvall, MD

Practitioner Nuclear Medicine Physician Charlottesville, VA

Practice location

Address: 1240 Lee St, Charlottesville, VA 22908-0817
Phone: (434) 924-9333
Fax: (434) 243-3938
Mailing address: PO Box 9007, Charlottesville, VA 22906-9007

Registered specialties

Nuclear Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207U00000X Licence 0101268271 (VA)

Other Nuclear Medicine providers in Virginia →

Registry record

NPI: 1891988242
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Aug 2007
Record last updated: 8 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.