Provider Demographics
NPI:1023488871
Name:MINOR, SCOTT M (PA-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:MINOR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1700 OLD GATESBURG RD STE 200
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2276
Mailing Address - Country:US
Mailing Address - Phone:814-237-4321
Mailing Address - Fax:814-235-0484
Practice Address - Street 1:1700 OLD GATESBURG RD STE 200
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2276
Practice Address - Country:US
Practice Address - Phone:814-237-4321
Practice Address - Fax:814-235-0484
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2021-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOA004960363A00000X
IN99069474A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant