Provider Demographics
NPI:1578692257
Name:SCOTT HOUSER, MD, PA
Entity Type:Organization
Organization Name:SCOTT HOUSER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-633-1263
Mailing Address - Street 1:PO BOX 8286
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-8286
Mailing Address - Country:US
Mailing Address - Phone:302-633-1263
Mailing Address - Fax:
Practice Address - Street 1:5239 W WOODMILL DR
Practice Address - Street 2:SUITE 49
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-633-1263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100057262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000396679OtherMEDICAID SECONDARY ID
DE4415OtherUNITED BEHAV. HEALTH ID
DE1000030589Medicaid
DE1000030589Medicaid