Provider Demographics
NPI:1700844461
Name:SCOTT, VALERIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1400 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-884-1341
Practice Address - Fax:843-884-1345
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC124680Medicaid
SCP00352692OtherRR MEDICARE
SCP00754350OtherRAILROAD MC ID-RSFPN
SCP00754350OtherRAILROAD MC ID-RSFPN
SCC080716795Medicare PIN
SC124680Medicaid
SCC080719223Medicare PIN
SCC080714888Medicare PIN
SCC080715551Medicare PIN
SC1689624447Medicare PIN