Provider Demographics
NPI:1730219205
Name:HOVIS, SCOTT MARION (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MARION
Last Name:HOVIS
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:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-2848
Mailing Address - Fax:864-512-7221
Practice Address - Street 1:100 HEALTHY WAY STE 1240
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-512-2848
Practice Address - Fax:864-512-7221
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006007662086S0129X
SC236122086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA39355019OtherMEDICARE PIN
SC236122Medicaid
SCP00741271OtherRAILROAD MEDICARE
NC2074203OtherMEDICARE PROVIDER NUMBER
SCP00766580OtherRAIL ROAD MEDICARE
NC5907638Medicaid
SCAA39353365OtherNEDICARE PIN