Provider Demographics
NPI:1518906726
Name:SPRINGER, SCOTT ADAM (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ADAM
Last Name:SPRINGER
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 1:994 W SHERMAN AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6937
Mailing Address - Country:US
Mailing Address - Phone:631-534-7246
Mailing Address - Fax:856-457-5681
Practice Address - Street 1:994 W SHERMAN AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6937
Practice Address - Country:US
Practice Address - Phone:631-534-7246
Practice Address - Fax:856-457-5681
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2087372085P0229X, 2085R0202X
NJ2085R0202X2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY977051Medicare ID - Type UnspecifiedINDIVIDUAL
NYH20000Medicare UPIN