Provider Demographics
NPI:1316576374
Name:SCOTT, COLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18 LEONARDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2311
Mailing Address - Country:US
Mailing Address - Phone:732-671-0860
Mailing Address - Fax:732-671-6467
Practice Address - Street 1:18 LEONARDVILLE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2311
Practice Address - Country:US
Practice Address - Phone:732-671-0860
Practice Address - Fax:732-671-6467
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11786900207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine