1801863162 NPI number — DR. SCOTT HARRIS SAFFOLD M.D.

Table of content: DR. SCOTT HARRIS SAFFOLD M.D. (NPI 1801863162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801863162 NPI number — DR. SCOTT HARRIS SAFFOLD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAFFOLD
Provider First Name:
SCOTT
Provider Middle Name:
HARRIS
Provider Name Prefix Text:
DR.
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:
1801863162
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36080 LANKFORD HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLE HAVEN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23306-1100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-442-7040
Provider Business Mailing Address Fax Number:
757-442-7080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36080 LANKFORD HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE HAVEN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23306-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-442-7040
Provider Business Practice Location Address Fax Number:
757-442-7080
Provider Enumeration Date:
03/07/2006

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: 207Y00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 188364 . This is a "MARYLAND PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 236033 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 39811 . This is a "SENTARA PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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