Provider Demographics
NPI:1811004435
Name:BERMAN, SCOTT STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:STEVEN
Last Name:BERMAN
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 1:3709 N CAMPBELL AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1563
Mailing Address - Country:US
Mailing Address - Phone:520-838-3540
Mailing Address - Fax:520-325-3526
Practice Address - Street 1:1815 W ST MARYS RD
Practice Address - Street 2:
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2653
Practice Address - Country:US
Practice Address - Phone:520-628-1400
Practice Address - Fax:520-628-4863
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ206432086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ164731Medicaid
000617077OtherHUMANA
102550OtherRR MC PIN
AZ102550OtherRR MC PIN
164731OtherAHCCCS
102551OtherMC COCHISE
AZ102551OtherRR MC PIN
AZ081990OtherAZ BCBS
AZP00806843OtherRR MEDICARE
AZ102542OtherRR MC GRP
005502968OtherAZ HEALTH PLAN
102550OtherMC PIMA
DD0329OtherTRAVELERS MC
102542OtherRR MC GRP
1147063OtherFIRST HEALTH
1254715OtherCIGNA
164731OtherINDIAN HEALTH
4643399OtherAETNA
102551OtherMC COCHISE
1147063OtherFIRST HEALTH
1254715OtherCIGNA