Provider Demographics
NPI:1740309392
Name:SCANDINARO, DAVID WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WILLIAM
Last Name:SCANDINARO
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 1:500 W WILSON BRIDGE RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2238
Mailing Address - Country:US
Mailing Address - Phone:614-885-3707
Mailing Address - Fax:614-847-9322
Practice Address - Street 1:500 W WILSON BRIDGE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2238
Practice Address - Country:US
Practice Address - Phone:614-885-3707
Practice Address - Fax:614-847-9322
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 0625102084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry