Provider Demographics
NPI:1063484947
Name:COLE, SCOTT C (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-7084
Mailing Address - Fax:540-564-6847
Practice Address - Street 1:2010 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-1110
Practice Address - Fax:540-689-1119
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA183899OtherANTHEM- STRASBURG
VA292395OtherANTHEM- WOODSTOCK
VA010203261Medicaid
VA020620218OtherTAX ID#
VA006736190Medicaid
VA010203261Medicaid