Provider Demographics
NPI:1740327121
Name:SCATTERGOOD, EMILY D (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:D
Last Name:SCATTERGOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLAZA
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:ONE COOPER PLAZA
Practice Address - Street 2:COOPER UNIVERSITY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2380
Practice Address - Fax:856-365-0472
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0831382085R0202X
PAMD4289442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01004598300OtherAMERICHOICE
NJ0186440OtherCIGNA
NJ1666625OtherAETNA
NJ60035051OtherHORIZON NJ HEALTH
NJ3424673000OtherAMERIHEALTH/KEYSTONE/IBC
NJ2706079OtherUNITED HEALTHCARE