Healthcare Provider Details

I. General information

NPI: 1932212248
Provider Name (Legal Business Name): DAVID JOHN SCHENGBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J CLYDE MORRIS BLVD RIVERSIDE REGIONAL MEDICAL COMPLEX
NEWPORT NEWS VA
23601
US

IV. Provider business mailing address

PO BOX 12087
NEWPORT NEWS VA
23612-2087
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-4405
  • Fax: 757-594-3547
Mailing address:
  • Phone: 757-867-6101
  • Fax: 757-867-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101052499
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: