Healthcare Provider Details

I. General information

NPI: 1619178159
Provider Name (Legal Business Name): SCOTT MICHAEL DEMBIEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PATIENTS FIRST DR STE 2742
WASHINGTON MO
63090-4700
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-8825
  • Fax:
Mailing address:
  • Phone: 636-239-8825
  • Fax: 636-390-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2009018136
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006019871
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: