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General NPI Number Information
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NPI Number | 1437202116
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Entity Type | Individual
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Provider Name | SCOTT ROBERT SHARETTS MD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 101 BURRS RD STE C
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City | WESTAMPTON
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State | NJ
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Zip | 08060-5517
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Country | US
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Telephone | 609-871-7500
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Fax | 609-444-5657
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax | 856-355-0330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA04242500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD030059E
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | MD030059E
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | 25MA04242500
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License Number State | NJ
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