Provider Demographics
NPI:1659574044
Name:ROBERT G SCARCELLA MD INC
Entity Type:Organization
Organization Name:ROBERT G SCARCELLA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:SCARCELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-848-9209
Mailing Address - Street 1:101 FIFTH ST SE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-848-9209
Mailing Address - Fax:330-848-9210
Practice Address - Street 1:101 FIFTH ST SE
Practice Address - Street 2:SUITE E
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203
Practice Address - Country:US
Practice Address - Phone:330-848-9209
Practice Address - Fax:330-848-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH38612208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R09346831Medicare ID - Type Unspecified