Basic Information
| Provider Information | |||||||||
| NPI: | 1770500472 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AUGUSTINE | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 603 BEAMAN ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CLINTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283282650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105908050 | ||||||||
| FaxNumber: | 9105908052 | ||||||||
| Practice Location | |||||||||
| Address1: | 603 BEAMAN ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CLINTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283282650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105908050 | ||||||||
| FaxNumber: | 9105908052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 12/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2010-00213 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.