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NPI Code Detail

MEDICARE: DR. SCOTT JAMES IWASHYNA M.D.

MEDICARE: DR. SCOTT JAMES IWASHYNA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician010124732VA

General Provider Information

NPI Number : 1720292600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT JAMES IWASHYNA M.D.
Provider Business Mailing Address
First Line : 5408 BEWDLEY RD
Second Line :
City : RICHMOND
State : VA
Zip : 23226-2108
Country : US
Telephone Number : 804-475-2637
Fax Number :
Provider Business Practice Location Address
First Line : 9606 PATTERSON AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23229-6027
Country : US
Telephone Number : 804-740-6171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 10/14/2009

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