Provider Demographics
NPI:1366472573
Name:CARNIVALE, SCOTT PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PAUL
Last Name:CARNIVALE
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 1:3720 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3520
Mailing Address - Country:US
Mailing Address - Phone:412-882-9455
Mailing Address - Fax:412-884-6149
Practice Address - Street 1:3720 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3520
Practice Address - Country:US
Practice Address - Phone:412-882-9455
Practice Address - Fax:412-884-6149
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 048928L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01402496Medicaid
PAE12760Medicare UPIN
PA606797Medicare ID - Type Unspecified