Provider Demographics
NPI:1366533184
Name:BEATTIE, SCOTT W (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:BEATTIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1522 OLD BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4854
Mailing Address - Country:US
Mailing Address - Phone:315-797-2450
Mailing Address - Fax:315-792-4641
Practice Address - Street 1:1522 OLD BURRSTONE RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4804
Practice Address - Country:US
Practice Address - Phone:315-797-2450
Practice Address - Fax:315-792-4641
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY223673207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02238315Medicaid