Provider Demographics
NPI:1992757942
Name:VAN SCOY, STEVEN CLARK (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CLARK
Last Name:VAN SCOY
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 1:5355 CANDELABRA PL
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-8397
Mailing Address - Country:US
Mailing Address - Phone:805-547-1538
Mailing Address - Fax:805-783-2260
Practice Address - Street 1:1010 MURRAY ST
Practice Address - Street 2:NICU
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-8800
Practice Address - Country:US
Practice Address - Phone:805-546-7899
Practice Address - Fax:805-546-7982
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG837582080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine