Provider Demographics
NPI:1699895441
Name:CHERRY, SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:CHERRY
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 1:955 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3799
Mailing Address - Country:US
Mailing Address - Phone:717-846-3457
Mailing Address - Fax:717-845-1865
Practice Address - Street 1:955 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3799
Practice Address - Country:US
Practice Address - Phone:717-846-3457
Practice Address - Fax:717-845-1865
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022730E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01533401OtherBLUE CROSS KEYSTONE
PA4412116OtherAETNA PPO
PA02527400OtherBLUE CROSS KEYSTONE
PA2264OtherHEALTH AMERICA
PA0011866500003Medicaid
PA130001461OtherRR MEDICARE
PA000000105928OtherUNISON
PA0482077OtherAETNA POS
PA095174OtherBLUE SHIELD
PA1508840OtherGATEWAY
PAB36203OtherSOUTH CENTRAL PREFERRED
PA20009573OtherAMERIHEALTH MERCY
PAB36203OtherSOUTH CENTRAL PREFERRED
PA095174OtherBLUE SHIELD