Provider Demographics
NPI:1063512150
Name:VERGANO, SCOTT TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:TODD
Last Name:VERGANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:885 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-461-6342
Mailing Address - Fax:757-461-8507
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-461-6342
Practice Address - Fax:757-461-8507
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251970208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics