Provider Demographics
NPI:1477654374
Name:SCOTT, BURTON LASATER (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:LASATER
Last Name:SCOTT
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 1:932 MORREENE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4410
Mailing Address - Country:US
Mailing Address - Phone:919-668-2493
Mailing Address - Fax:919-681-4935
Practice Address - Street 1:932 MORREENE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4410
Practice Address - Country:US
Practice Address - Phone:919-668-2493
Practice Address - Fax:919-681-4935
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94006312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9400631OtherMEDICAL LICENSE NUMBER
NC9400631OtherMEDICAL LICENSE NUMBER
NCBS4393106OtherDEA NUMBER