Individual
SCOTT JAMES TYREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-5645
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NC
208VP0014X
Interventional Pain Medicine Physician
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132C8
BCBS NC
NC
01
—
46025
PARTNERS
NC
01
—
5244260
CIGNA
NC
05
—
89132C8
—
NC
01
—
B4817
MEDCOST
NC
Enumeration date
09/12/2006
Last updated
12/11/2007
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