Organization
GYN ONCOLOGY OF SOUTHWEST VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE BERGAMO (VP)
(804) 267-5950
Entity
Organization
Contact information
Practice address
1900 ELECTRIC RD, SUITE 200, SALEM, VA 24153-7474
(540) 776-4704
(540) 769-2453
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093750879
—
VA
05
—
3810000448
—
WV
Enumeration date
06/17/2006
Last updated
11/20/2025
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