Provider Demographics
NPI:1326154055
Name:DIEDE, SCOTT J (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:DIEDE
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:351 N SUMNEYTOWN PIKE
Mailing Address - Street 2:MAIL STOP UG4D-72
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2505
Mailing Address - Country:US
Mailing Address - Phone:267-305-5994
Mailing Address - Fax:267-305-6537
Practice Address - Street 1:351 N SUMNEYTOWN PIKE
Practice Address - Street 2:MAIL STOP UG4D-72
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2505
Practice Address - Country:US
Practice Address - Phone:267-305-5994
Practice Address - Fax:267-305-6537
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2015-05-08
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4534522080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology