Individual
R SCOTT HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
15 CHALLENGER DR, LEWISTON, ME 04240-1041
(207) 753-4601
Mailing address
15 CHALLENGER DR, LEWISTON, ME 04240-1041
(207) 753-4601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19920
ME
207R00000X
Internal Medicine Physician
ME91860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02036
UNIVERSAL HEALTH CARE
FL
01
—
101844
MEDICARE A
—
01
—
21250921881
BEECHSTREET/CAPP CARE
FL
05
—
271800600
—
FL
01
—
52159
BLUE CROSS BLUE SHIELD
FL
01
—
P00169584
RR MEDICARE
FL
01
—
SG076504
VISTA
FL
Enumeration date
06/20/2005
Last updated
08/01/2014
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