1497850515 NPI number — BENJAMIN S SCHARFSTEIN M.D.

Table of content: BENJAMIN S SCHARFSTEIN M.D. (NPI 1497850515)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497850515 NPI number — BENJAMIN S SCHARFSTEIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHARFSTEIN
Provider First Name:
BENJAMIN
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497850515
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 MEDICAL PARK BLVD
Provider Second Line Business Mailing Address:
250 WEST
Provider Business Mailing Address City Name:
BRISTOL
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37620-7430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-844-6620
Provider Business Mailing Address Fax Number:
423-844-6627

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MEDICAL PARK BLVD
Provider Second Line Business Practice Location Address:
250 WEST
Provider Business Practice Location Address City Name:
BRISTOL
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37620-7430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-844-6620
Provider Business Practice Location Address Fax Number:
423-844-6627
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  34037 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3882258 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 266804 . This is a "INDIV ANTHEM/GROUP#093410" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: TN0107 . This is a "JOHN DEERE NOW UNITED HC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 022276800 . This is a "BLACK LUNG GROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7314019 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0636398 . This is a "UMWA GROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4059514 . This is a "BCBS OF TENNESSEE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: P00007322 . This is a "MCRAILROAD/GROUP#CA8128" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7032445 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: F03906748 . This is a "CHAMPUS GROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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