Provider Demographics
NPI:1134221393
Name:FERREIRA, SCOTT W (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S NATIONAL AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5228
Mailing Address - Country:US
Mailing Address - Phone:417-875-2624
Mailing Address - Fax:314-577-8861
Practice Address - Street 1:3800 S NATIONAL AVE STE 160
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5228
Practice Address - Country:US
Practice Address - Phone:417-875-2624
Practice Address - Fax:314-577-8861
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41253207R00000X
MO2008021978207R00000X, 207RC0000X, 207RC0001X
IN01067980A207RC0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204404909Medicaid
I70805Medicare UPIN
INM400014972Medicare PIN