Individual
DUSTIN SHANE SYVERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1914 THOMSON DR, LYNCHBURG, VA 24501-1009
(434) 947-3925
Mailing address
1914 THOMSON DR, LYNCHBURG, VA 24501-1009
(434) 947-3925
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101271678
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2016
Last updated
05/21/2021
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