Individual
SCOTT TIEDEBOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 MONUMENT RD STE 295, YORK, PA 17403-5049
(717) 356-5864
(717) 409-6221
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 356-5864
(717) 409-6221
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD464828
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035840960001
—
PA
Enumeration date
05/13/2011
Last updated
02/27/2024
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