MEDICARE: SCOTT GILBERT STROKER D.C.

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	111N00000X	Chiropractor	1592	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08819	OTHER	NC	CNC
2	641206	OTHER	NC	CIGNA/UHC
3	FH700165	OTHER	NC	FIRST CAROLINA CARE
4	08226	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1174704969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT GILBERT STROKER D.C.

Provider Business Mailing Address
First Line	:	240 MAGNOLIA SQUARE CT
Second Line	:
City	:	ABERDEEN
State	:	NC
Zip	:	28315-2226
Country	:	US
Telephone Number	:	910-944-1481
Fax Number	:	910-944-1481

Provider Business Practice Location Address
First Line	:	240 MAGNOLIA SQUARE CT
Second Line	:
City	:	ABERDEEN
State	:	NC
Zip	:	28315-2226
Country	:	US
Telephone Number	:	910-944-1481
Fax Number	:	910-944-1481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	11/20/2007

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