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Individual

SCOTT L VANDIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
895 STATE FARM RD STE 401, BOONE, NC 28607-4917
(828) 264-4691
(828) 265-4288
Mailing address
562 WINDWOOD LN, BOONE, NC 28607-7089
(828) 963-3867

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28584
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8984686
NC
Enumeration date
08/17/2006
Last updated
03/30/2016
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