Provider Demographics
NPI:1235199035
Name:LEVY, SCOTT S (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:S
Last Name:LEVY
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 1:599 W STATE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-348-8020
Mailing Address - Fax:215-348-7002
Practice Address - Street 1:599 W STATE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2567
Practice Address - Country:US
Practice Address - Phone:215-348-8020
Practice Address - Fax:215-348-7002
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040574L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014850780001Medicaid
PAE74000Medicare UPIN
PA024288Medicare ID - Type Unspecified