# DR. SCOTT ALLEN RICCIARDI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1912902974
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1929 | OH | Yes |

## Other

- **Enumeration date:** 06/16/2005
- **Last updated:** 10/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000137719 | ANTHEM BC/BS PROVIDER ID | — |
| 05 | — | 0131937000 | — | WV |
| 05 | — | 0928563 | — | OH |
| 01 | — | 622722 | HIGHMARK BCBS | — |
| 05 | — | 9044330 | — | OH |