Provider Demographics
NPI:1508952367
Name:UNICE, SCOTT DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:DOUGLAS
Last Name:UNICE
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 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:1034 NORTH 500 WEST
Practice Address - Street 2:UTAH VALLEY REGIONAL MEDICAL CENTER
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604
Practice Address - Country:US
Practice Address - Phone:801-507-5248
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT187615-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT231618OtherDESERET MUTUAL
UT40321OtherPEHP
AZ820911Medicaid
UT870545614UN1OtherEDUCATORS MUTUAL
WY111119100Medicaid
UT53280OtherHEALTHY U
UT8597445OtherWORKERS COMP
UT107007381102OtherIHC
UT1502954OtherUMWA
UTPR00823OtherMOLINA
ID001607000Medicaid
UTQM0000075886OtherALTIUS
NV002082466Medicaid
UT2090168OtherUNITED HEALTHCARE
UT870545614UN1OtherEDUCATORS MUTUAL
UT53280OtherHEALTHY U
UT107007381102OtherIHC