Provider Demographics
NPI:1699735969
Name:SCOVERN, HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:SCOVERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1150 BERKSHIRE BLVD.
Mailing Address - Street 2:SUITE 170
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1233
Mailing Address - Country:US
Mailing Address - Phone:610-478-1737
Mailing Address - Fax:610-478-1407
Practice Address - Street 1:1150 BERKSHIRE BLVD.
Practice Address - Street 2:SUITE 170
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1233
Practice Address - Country:US
Practice Address - Phone:610-478-1737
Practice Address - Fax:610-478-1407
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027501E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMOS080OtherOXFORD HEALTH PLAN
PA0061713000OtherKEYSTONE HEALTH PLAN EAST
PA4280136OtherAETNA
PA01157101OtherCAPITAL BLUE CROSS
PA116629OtherPA BLUE SHIELD
PA00617130000OtherINDEPENDENCE BLUE CROSS
PA0061713000OtherKEYSTONE HEALTH PLAN EAST
PA01157101OtherCAPITAL BLUE CROSS