Provider Demographics
NPI:1487723003
Name:CHIRICHETTI, SCOTT D (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:CHIRICHETTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RAY C HUNT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2981
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2050 ABBEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3553
Practice Address - Country:US
Practice Address - Phone:434-295-3600
Practice Address - Fax:434-220-0121
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201689208100000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00733689Medicare PIN
VA018967C15Medicare PIN