Healthcare Provider Details

I. General information

NPI: 1598772246
Provider Name (Legal Business Name): SCOTT M MEYERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA RD SUITE 203 MID-ATLANTIC GI CONSULTANTS
NEWARK DE
19713
US

IV. Provider business mailing address

537 STANTON CHRISTIANA RD SUITE 203 MID-ATLANTIC GI CONSULTANTS
NEWARK DE
19713
US

V. Phone/Fax

Practice location:
  • Phone: 302-225-2380
  • Fax: 302-225-2388
Mailing address:
  • Phone: 302-225-2380
  • Fax: 302-225-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC10005346
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: