Provider Demographics
NPI:1447864111
Name:SCOTT, STUART A (PHD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 HILLVIEW AVE RM 1810
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1204
Mailing Address - Country:US
Mailing Address - Phone:646-706-2097
Mailing Address - Fax:
Practice Address - Street 1:3375 HILLVIEW AVE RM 1810
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1204
Practice Address - Country:US
Practice Address - Phone:646-706-2097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTP-02129973207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology