Basic Information
Provider Information
NPI: 1265482228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCOTT
FirstName: STEVEN
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 783311
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191783311
CountryCode: US
TelephoneNumber: 4848844500
FaxNumber: 4848840699
Practice Location
Address1: 1200 S CEDAR CREST BLVD
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036202
CountryCode: US
TelephoneNumber: 6104025369
FaxNumber: 6104025959
Other Information
ProviderEnumerationDate: 05/11/2006
LastUpdateDate: 02/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD029549EPAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XMD029549EPAY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
11009075601PAPALMETTO RROTHER
0105490101PACAPITAL BLUE CROSSOTHER
46729901PAHIGHMARK PA BLUE SHIELDOTHER


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