Provider Demographics
NPI:1437123494
Name:LA PIDUS, A SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:A
Middle Name:SCOTT
Last Name:LA PIDUS
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:UNIVERSITY DRIVE C
Mailing Address - Street 2:132X-U
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-360-1209
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:132X-U
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-360-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063912L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001671770Medicaid
PAG86321Medicare UPIN
PA023369G89Medicare ID - Type Unspecified