Provider Demographics
NPI:1245298009
Name:DREW, GEORGE SCOTT (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:SCOTT
Last Name:DREW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 HARDING MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6365
Mailing Address - Country:US
Mailing Address - Phone:740-244-8550
Mailing Address - Fax:740-751-4584
Practice Address - Street 1:1063 HARDING MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6365
Practice Address - Country:US
Practice Address - Phone:740-244-8550
Practice Address - Fax:740-751-4584
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005471D207N00000X
OH34.005471207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
311098079OtherPPO NEXT
353077OtherSUBMITTER NO.
311098079032OtherCIGNA
644354OtherAETNA
070005252OtherTRAVELERS MEDICARE
31109807OtherTAX ID #
OH00000018447OtherANTHEM
OH0855454Medicaid
0300147OtherUHC
0712251OtherPALMETTO MEDICARE
OH0712251Medicare ID - Type Unspecified
353077OtherSUBMITTER NO.
OH0855454Medicaid