Provider Demographics
NPI:1417984774
Name:SCOTT A DINESEN FACOG, PC
Entity Type:Organization
Organization Name:SCOTT A DINESEN FACOG, PC
Other - Org Name:DINESEN & ASSOCIATES OB/GYN & INFERTILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DINESEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-489-2066
Mailing Address - Street 1:599 W STATE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-489-2066
Mailing Address - Fax:215-489-1166
Practice Address - Street 1:599 W STATE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2567
Practice Address - Country:US
Practice Address - Phone:215-489-2066
Practice Address - Fax:215-489-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007938L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015164050005Medicaid
PA088212Medicare ID - Type Unspecified
PAF98177Medicare UPIN