MEDICARE: HENRICO DOCTORS NEUROLOGY ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760542591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRICO DOCTORS NEUROLOGY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	2000 HEALTH PARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4692
Country	:	US
Telephone Number	:	615-373-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	7607 FOREST AVE STE 300
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4913
Country	:	US
Telephone Number	:	804-228-2742
Fax Number	:	804-288-9053

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	SUZANNE BERGAMO
Credential	:
Telephone Number	:	804-446-9440

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	11/20/2025

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