Provider Demographics
NPI:1336196203
Name:SAILER, SCOTT LEE
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LEE
Last Name:SAILER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60106
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0106
Mailing Address - Country:US
Mailing Address - Phone:919-854-4588
Mailing Address - Fax:919-854-9950
Practice Address - Street 1:300 ASHVILLE AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8682
Practice Address - Country:US
Practice Address - Phone:919-854-4588
Practice Address - Fax:919-854-9950
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC328482085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC183764OtherWELLPATH
NC24-55038OtherUNITED HEALTHCARE
NC4453810OtherAETNA
NC8974222Medicaid
NC920007517OtherRAILROAD MEDICARE
NCC2723OtherMEDCOST
NC74222OtherBLUECROSS BLUESHIELD
NC183764OtherWELLPATH
NC920007517OtherRAILROAD MEDICARE