Provider Demographics
NPI:1245338532
Name:YEAW, SCOTT C (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:YEAW
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 1:403 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9614
Mailing Address - Country:US
Mailing Address - Phone:610-837-9989
Mailing Address - Fax:
Practice Address - Street 1:403 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9614
Practice Address - Country:US
Practice Address - Phone:610-837-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019045E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007330730001Medicaid
B36685Medicare UPIN
NJ437413Medicare ID - Type Unspecified
PA106308Medicare ID - Type Unspecified