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General NPI Number Information
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NPI Number | 1023040409
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Entity Type | Individual
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Provider Name | NOEL MELINDA BERGQUIST MD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1924 ALCOA HWY # U107
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 865-305-9661
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Fax | 865-305-6148
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Provider Business Mailing Address
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Address Line | PO BOX 11167
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City | KNOXVILLE
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State | TN
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Zip | 37939-1167
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Country | US
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Telephone | 865-584-7376
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Fax | 865-540-3856
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 27626
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 107356
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2005-00699
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 47204
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 053098
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License Number State | GA
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