Provider Demographics
NPI:1255404950
Name:SCOTT, EDMUND SAWYER (DO)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:SAWYER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 COLESBERY DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3204
Mailing Address - Country:US
Mailing Address - Phone:302-328-1892
Mailing Address - Fax:
Practice Address - Street 1:136 COLESBERY DRIVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3204
Practice Address - Country:US
Practice Address - Phone:302-328-1892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20001394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DESC50548Medicare ID - Type Unspecified
50548Medicare UPIN