Provider Demographics
NPI:1255371605
Name:DENARDO, SCOTT JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:JEFFREY
Last Name:DENARDO
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 1:522 ALLEN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-2861
Mailing Address - Country:US
Mailing Address - Phone:910-571-5510
Mailing Address - Fax:
Practice Address - Street 1:522 ALLEN ST STE 101
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-2861
Practice Address - Country:US
Practice Address - Phone:910-571-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98342207RC0000X
NC9300079207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC110081947OtherPALMETTO GBA PROVIDER
SCN00079OtherSC MEDICAID PROVIDER
NCFH2000110OtherFIRSTCAROLINACARE PROV
FL278162000Medicaid
NC28341OtherBCBS NC PROVIDER
NC80117OtherMEDCOST PROVIDER
NC8928341Medicaid
NC2501601OtherEVERCARE
FL278162000Medicaid
NC80117OtherMEDCOST PROVIDER
NC2501601OtherEVERCARE