Provider Demographics
NPI:1891722716
Name:BARTLETT, SCOTT P (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 EAST PENN SQUARE
Mailing Address - Street 2:THE WANAMAKER BLDG. 9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S SURGICAL ASSOCIATES, LTD
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-590-2208
Practice Address - Fax:215-590-2496
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD033152E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010651800001Medicaid
PA475986Medicare ID - Type Unspecified
PA0010651800001Medicaid