Provider Demographics
NPI:1063525723
Name:CUDA, SCOTT PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PAUL
Last Name:CUDA
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:MADIGAN ARMY MEDICAL CENTER BLDG 9040A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-2300
Mailing Address - Fax:253-968-2895
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENU
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-7282
Practice Address - Country:US
Practice Address - Phone:253-968-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13103208800000X
GA0626712088P0231X
WA602121162088P0231X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA221411831AMedicaid
FC1505784OtherDEA
VAD000Medicare UPIN