Individual
DR. SCOT T BATEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PEDIATRIC CRITICAL CARE, WORCESTER, MA 01655-0002
(774) 442-2164
(774) 443-2062
Mailing address
PO BOX 4158348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
155242
MA
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
155242
MA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
155242
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110062635A
—
MA
Enumeration date
11/16/2005
Last updated
11/10/2020
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