Provider Demographics
NPI:1902484934
Name:BERG, SCOTT HILLIARD
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:HILLIARD
Last Name:BERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 LEE ST
Mailing Address - Street 2:P.O. BOX 800718, UVA HEALTH SYSTEM
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908
Mailing Address - Country:US
Mailing Address - Phone:434-924-5115
Mailing Address - Fax:434-244-4504
Practice Address - Street 1:1221 LEE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908
Practice Address - Country:US
Practice Address - Phone:434-924-5115
Practice Address - Fax:434-244-4504
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program