Provider Demographics
NPI:1003625765
Name:FIDDLER, SCOTT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:FIDDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 PURPLE MARTIN CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8323
Mailing Address - Country:US
Mailing Address - Phone:910-660-3138
Mailing Address - Fax:
Practice Address - Street 1:6420 PURPLE MARTIN CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8323
Practice Address - Country:US
Practice Address - Phone:910-660-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications