Healthcare Provider Details

I. General information

NPI: 1720423411
Provider Name (Legal Business Name): SCOTT STUDENY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

9500 EUCLID AVE # M-14
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-0921
  • Fax: 859-257-1831
Mailing address:
  • Phone: 216-296-4279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number129232
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number129232
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberTP909
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: