Provider Demographics
NPI:1871522292
Name:CUMMINGS, SCOTT W (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:CUMMINGS
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 1560
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910
Mailing Address - Country:US
Mailing Address - Phone:843-706-0600
Mailing Address - Fax:843-706-0601
Practice Address - Street 1:4818 BLUFFTON PKWY
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4602
Practice Address - Country:US
Practice Address - Phone:843-706-0600
Practice Address - Fax:843-706-0601
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055552207R00000X
SCMD28422207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF77513Medicare UPIN
GA93BBJDCMedicare ID - Type Unspecified