Provider Demographics
NPI:1851326573
Name:PADEN, SCOTT W (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:PADEN
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 1:1340 N GREAT NECK RD
Mailing Address - Street 2:SUITE 1272 PMB 390
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2268
Mailing Address - Country:US
Mailing Address - Phone:757-481-5858
Mailing Address - Fax:757-481-6265
Practice Address - Street 1:5232 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4202
Practice Address - Country:US
Practice Address - Phone:757-495-5003
Practice Address - Fax:757-495-9471
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045156207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00177120OtherRAILROAD MCR
VA153395OtherBCBS
VA010112265Medicaid
VAP00177120OtherRAILROAD MCR
VA010112265Medicaid
VAC10410Medicare PIN