Healthcare Provider Details

I. General information

NPI: 1376923011
Provider Name (Legal Business Name): JAMES C SCHOLFIELD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US ARMY MEDDAC BAVARIA CMR 411 BLDG 700 RM 6
APO AE
09112-0066
US

IV. Provider business mailing address

US ARMY MEDDAC BAVARIA CMR 411 BLDG 700 RM 6
APO AE
09112-0066
US

V. Phone/Fax

Practice location:
  • Phone: 314-494-8687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1669
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1669
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: