Provider Demographics
NPI:1194712976
Name:PIPER, SCOTT J (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:PIPER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1630 42ND ST NE
Mailing Address - Street 2:SUITE F
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3063
Mailing Address - Country:US
Mailing Address - Phone:319-261-1379
Mailing Address - Fax:319-261-1382
Practice Address - Street 1:1630 42ND ST NE
Practice Address - Street 2:SUITE F
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3063
Practice Address - Country:US
Practice Address - Phone:319-261-1379
Practice Address - Fax:319-261-1382
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2013-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA34569207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1258434Medicaid
H60606Medicare UPIN
IAI12962Medicare PIN