Provider Demographics
NPI:1497967756
Name:ARD, SCOTT WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WILLIAM
Last Name:ARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 896206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6206
Mailing Address - Country:US
Mailing Address - Phone:252-635-6777
Mailing Address - Fax:252-635-9661
Practice Address - Street 1:4252 ARENDELL ST
Practice Address - Street 2:SUITE E
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2866
Practice Address - Country:US
Practice Address - Phone:252-808-0145
Practice Address - Fax:252-808-2770
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2009-00575207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00828374OtherRAILROAD MEDICARE
NC153CROtherBCBSNC
P00828374OtherRAILROAD MEDICARE