Provider Demographics
NPI:1861482275
Name:CULP, SCOTT H (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:H
Last Name:CULP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:212 N MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454
Practice Address - Country:US
Practice Address - Phone:215-699-1501
Practice Address - Fax:215-699-1505
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010102L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023688740001Medicaid
PAP00358928Medicare PIN
PA1023688740001Medicaid
PA033687QZ7Medicare PIN
PA080164170Medicare PIN