Provider Demographics
NPI:1710253174
Name:VASCIK, SCOTT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:VASCIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 WALNUT BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-8131
Mailing Address - Country:US
Mailing Address - Phone:717-532-0175
Mailing Address - Fax:717-706-6705
Practice Address - Street 1:127 WALNUT BOTTOM RD
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-8131
Practice Address - Country:US
Practice Address - Phone:717-532-0175
Practice Address - Fax:717-706-6705
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26307208000000X
PAMD466101208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics