MEDICARE: SCOT DEPUE MD

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	208D00000X	General Practice Physician	MD426302	PA
2	207P00000X	Emergency Medicine Physician	MD426302	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1497167167	OTHER	PA	GROUP NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407808975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOT DEPUE MD

Provider Business Mailing Address
First Line	:	5000 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-9263
Country	:	US
Telephone Number	:	804-968-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 COLLEGE AVE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603
Country	:	US
Telephone Number	:	717-988-0000
Fax Number	:	717-782-5716

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	04/12/2026

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Directions to “ SCOT DEPUE MD” Practice Location

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