Provider Demographics
NPI:1780643395
Name:MALING, SCOTT N (DPM)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:N
Last Name:MALING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S DOBSON RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4725
Mailing Address - Country:US
Mailing Address - Phone:480-844-8218
Mailing Address - Fax:480-844-9950
Practice Address - Street 1:1520 S DOBSON RD
Practice Address - Street 2:SUITE 307
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4725
Practice Address - Country:US
Practice Address - Phone:480-844-8218
Practice Address - Fax:480-844-9950
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4490213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ429143Medicaid
AZAZ0825660OtherBLUE CROSS BLUE SHIELD
AZ1Z0710OtherHEALTHNET OF ARIZONA
AZAZ0825660OtherBLUE CROSS BLUE SHIELD
AZU70629Medicare UPIN
AZ0358770001Medicare NSC