Provider Demographics
NPI:1386641314
Name:WARSAW, DAVID SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:WARSAW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 NORTH DUKE STREET
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-291-5863
Mailing Address - Fax:717-392-6915
Practice Address - Street 1:554 NORTH DUKE STREET
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-291-5863
Practice Address - Fax:717-392-6915
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008999L208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001973074Medicaid
PA20069563OtherAMERIHEALTH MERCY-WMG
PA1391940OtherHIGHMARK BLUE SHIELD
PA211138OtherJOHNS HOPKINS
PA50074344OtherCAPITAL BLUE CROSS-WMG
PA7708373OtherAETNA
PA1536634OtherGATEWAY WMG
PA230031OtherUNISON-WMG
PA50074344OtherCAPITAL BLUE CROSS-WMG
PA001973074Medicaid
PA063548FLTMedicare PIN