Individual
DANIEL J SCODARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1000
Mailing address
2407 COUNTRY POINTE LN, WENTZVILLE, MO 63385-5435
(314) 960-0760
(636) 332-0316
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
ME127387
FL
207T00000X
Neurological Surgery Physician
Primary
R8N28
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130004994
RR MEDICARE
MO
01
—
30173
BLUE CROSS BLUE SHIELD
MO
01
—
PENDING
MEDICARE
FL
05
—
PENDING
—
FL
Enumeration date
10/07/2005
Last updated
04/07/2021
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