Healthcare Provider Details

I. General information

NPI: 1891766259
Provider Name (Legal Business Name): DAVID M SCOGGIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E WALNUT ST
LANCASTER OH
43130-4464
US

IV. Provider business mailing address

3270 OLD MILL RD NE
LANCASTER OH
43130-9750
US

V. Phone/Fax

Practice location:
  • Phone: 740-277-6043
  • Fax: 740-277-7595
Mailing address:
  • Phone: 740-215-3965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOH35-05-5843
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: