Provider Demographics
NPI:1336149145
Name:SAUER, SCOTT THOMAS (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:THOMAS
Last Name:SAUER
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:888-472-0043
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:300 CALLEN BLVD STE 330
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2816
Practice Address - Country:US
Practice Address - Phone:843-763-2857
Practice Address - Fax:843-606-8053
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034939207XX0004X
PAMD073243L207XX0004X
SC92172207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10196377800001Medicaid
PA10196377800001Medicaid
PA111373LPBMedicare PIN