Provider Demographics
NPI:1982662524
Name:MUIR, SCOTT DOUGLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DOUGLAS
Last Name:MUIR
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 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1000 ALLIANCE DR
Practice Address - Street 2:SUITE 10
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-3234
Practice Address - Country:US
Practice Address - Phone:570-501-6450
Practice Address - Fax:570-501-6436
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007301L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA078576OtherHMO
PA001459247-0004Medicaid
PA01459247Medicaid
767138Medicare ID - Type Unspecified