Individual
DR. BRIAN WITTMUS ZAGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
158 EXECUTIVE DR, DANVILLE, VA 24541-4100
(434) 791-1088
(434) 799-8525
Mailing address
201 S MAIN ST STE 1100, DANVILLE, VA 24541-2938
(434) 791-1088
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101234822
VA
207RC0000X
Cardiovascular Disease Physician
39369
TN
207RI0011X
Interventional Cardiology Physician
Primary
0101234822
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3337419
—
TN
01
—
4121983
BLUE CROSS
TN
Enumeration date
09/14/2006
Last updated
11/06/2022
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