Healthcare Provider Details

I. General information

NPI: 1497749006
Provider Name (Legal Business Name): PATRICIA A.L. SCOTT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 FOULK RD
WILMINGTON DE
19803-2796
US

IV. Provider business mailing address

32 HUNT MEET LN
BOOTHWYN PA
19061-1224
US

V. Phone/Fax

Practice location:
  • Phone: 302-762-6222
  • Fax: 302-764-6058
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0003538
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: