Individual
SCOTT RYAN DUBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD421925
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD421925
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000275213
UNISON
PA
05
—
0065447
—
NJ
05
—
1011424240
—
PA
01
—
1582557P
GATEWAY
—
01
—
1609880
HIGHMARK BLUE SHIELD
PA
01
—
2287511000
INDEPENDENCE BLUE CROSS
PA
01
—
232040568
DEVON HEALTH PLAN
PA
01
—
50085608
CAPITAL ADVANTAGE
PA
01
—
P00735624
RAIL ROAD
PA
Enumeration date
12/13/2006
Last updated
06/01/2023
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