Provider Demographics
NPI:1770795486
Name:COMMINS, SCOTT P (MD, PHD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:COMMINS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 CALDERON DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4415
Mailing Address - Country:US
Mailing Address - Phone:434-882-3338
Mailing Address - Fax:984-974-2660
Practice Address - Street 1:100 EASTOWNE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2286
Practice Address - Country:US
Practice Address - Phone:984-974-2645
Practice Address - Fax:984-974-2660
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245489207K00000X
VA0116016518390200000X
NC2015-01834207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1770795486Medicaid