Provider Demographics
NPI:1598751323
Name:MASTERSON, SCOTT ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ROBERT
Last Name:MASTERSON
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 1:10 CORTLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-365-7548
Mailing Address - Fax:
Practice Address - Street 1:10 CORTLAND DRIVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-365-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8092208100000X, 2081P2900X
MA70585208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0003756OtherNHP
MA4374984OtherAETNA
MA80317OtherHPHC
MAJ08600OtherBCBS
NH0102646Y0MA01OtherANTHEM
MA23-00143OtherEVERCARE
MA3052303Medicaid
MA0035350-001OtherCIGNA
MA23592OtherFCHP
NH3003093Medicaid
MA715271OtherTHP
MA23-00008OtherUHC
MA23-00008OtherUHC
MA23592OtherFCHP
MA0003756OtherNHP