Individual
DR. SCOTT H ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1303 AZALEA CT, SUITE C, MYRTLE BEACH, SC 29577-5765
(843) 692-0570
(843) 497-9566
Mailing address
1303 AZALEA CT, STE C, MYRTLE BEACH, SC 29577-5765
(843) 692-0570
(843) 497-9566
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18517
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066EJ
BCBS OF NORTH CAROLINA
NC
01
—
154758900
FEDERAL BLACK LUNG
SC
05
—
185178
—
SC
01
—
570525838
STANDARD TAX ID
SC
05
—
89066EJ
—
NC
01
—
B9734
MEDCOST
SC
Enumeration date
09/29/2005
Last updated
09/13/2016
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