Provider Demographics
NPI:1548239619
Name:SCOLES, PETER VINCENT (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:VINCENT
Last Name:SCOLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3102
Mailing Address - Country:US
Mailing Address - Phone:215-590-9666
Mailing Address - Fax:215-590-9440
Practice Address - Street 1:3750 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3102
Practice Address - Country:US
Practice Address - Phone:215-590-9666
Practice Address - Fax:215-590-9440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016646E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery