Provider Demographics
NPI:1467532036
Name:FERREIRA, SCOTT TAVARES (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:TAVARES
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SEELEY LN
Mailing Address - Street 2:
Mailing Address - City:ELIOT
Mailing Address - State:ME
Mailing Address - Zip Code:03903
Mailing Address - Country:US
Mailing Address - Phone:207-439-9242
Mailing Address - Fax:207-438-0246
Practice Address - Street 1:6 SEELEY LN
Practice Address - Street 2:
Practice Address - City:ELIOT
Practice Address - State:ME
Practice Address - Zip Code:03903
Practice Address - Country:US
Practice Address - Phone:207-439-9242
Practice Address - Fax:207-438-0246
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1144111N00000X
NH625-0201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME271600099Medicaid
ME271600099Medicaid