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Individual

DR. NOEL MELINDA BERGQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1924 ALCOA HWY # U107, KNOXVILLE, TN 37920-1511
(865) 305-9661
(865) 305-6148
Mailing address
PO BOX 11167, KNOXVILLE, TN 37939-1167
(865) 584-7376
(865) 540-3856

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
053098
GA
2085R0202X
Diagnostic Radiology Physician
107356
FL
2085R0202X
Diagnostic Radiology Physician
2005-00699
NC
2085R0202X
Diagnostic Radiology Physician
27626
AL
2085R0202X
Diagnostic Radiology Physician
Primary
47204
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47BBBFQ
MEDICARE - IDTF COLUMBUS DIAGNOSTIC
GA
01
GRP2151
MEDICARE GROUP NUMBER COLUMBUS DIAGNOSTIC
GA
05
Q009031
TN
Enumeration date
07/07/2006
Last updated
09/24/2024
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