Provider Demographics
NPI:1790799237
Name:SCOTT, STEPHEN SHERROD (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SHERROD
Last Name:SCOTT
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 1:335 E PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5112
Mailing Address - Country:US
Mailing Address - Phone:828-433-1000
Mailing Address - Fax:828-433-6274
Practice Address - Street 1:335 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5112
Practice Address - Country:US
Practice Address - Phone:828-433-1000
Practice Address - Fax:828-433-6274
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300704207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134K3Medicaid
NC134K3OtherBLUE CROSS BLUE SHIELD NC
2015925FMedicare PIN
NC2015925AMedicare PIN
NC2015925Medicare PIN
NC2015925FMedicare PIN
NCP00118046Medicare PIN
H35707Medicare UPIN
NC2015925EMedicare PIN
NC2015925CMedicare PIN
NC134K3OtherBLUE CROSS BLUE SHIELD NC
NC2015925DMedicare PIN