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General NPI Number Information
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NPI Number | 1013048503
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Entity Type | Organization
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Legal Business Name | DENNIS M SCULLY, MD
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 3822 SCHAPER AVE
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City | ERIE
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State | PA
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Zip | 16508-3344
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Country | US
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Telephone | 814-868-0943
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Fax | 814-866-1160
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Provider Business Mailing Address
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Address Line | 3822 SCHAPER AVE
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City | ERIE
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State | PA
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Zip | 16508-3344
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Country | US
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Telephone | 814-868-0943
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Fax | 814-866-1160
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DENNIS M SCULLY
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Credential | M.D.
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Telephone | 814-868-0943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD017266E
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License Number State | PA
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