Provider Demographics
NPI:1154384170
Name:STERLING, SCOTT W (DO)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:W
Last Name:STERLING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:71 HOSPITAL DR
Mailing Address - Street 2:PHYSICIANCARE, P.C.
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9702
Mailing Address - Country:US
Mailing Address - Phone:570-265-6300
Mailing Address - Fax:570-268-2807
Practice Address - Street 1:71 HOSPITAL DR
Practice Address - Street 2:PHYSICIANCARE, P.C.
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-9702
Practice Address - Country:US
Practice Address - Phone:570-265-6300
Practice Address - Fax:570-268-2807
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS008617L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015977080008Medicaid
PA0015977080008Medicaid
PA201606193OtherEIN
PA0015977080008Medicaid